Written By Divya Rao on July 12, 2023

The Affordable Care Act (ACA) was created in March 2010 under the Obama administration. The main aspects of the act included expanding health insurance coverage to more people by attempting to reduce discrimination between health insurance applicants. The main problem that led to the creation of the ACA was the significant disparity in healthcare access in America between the rich and the poor. In addition, general rising healthcare costs led to a need for healthcare reform.   

Do the goals of the Affordable Care Act Contribute to a Better Quality of Life?

The Affordable Care Act’s goal of expanding healthcare does contribute to a better quality of life to some extent. More specifically, the act has helped rural communities in the US who did not have access to healthcare. For example, according to americanprogress.org, half of people in rural communities benefit from Medicaid coverage. In addition, more than 100 hospitals have closed in rural communities recently, and most of these hospitals have been in states that have not expanded Obamacare (Rapfogel et al., 2020). As a result, in rural communities, the Affordable Care Act would contribute to a better quality of life since the Affordable Care Act does cover and allow people in these rural communities to access more affordable healthcare. Also, having more affordable healthcare means that people in rural communities can get care in hospitals if needed. As a result, hospitals are utilized more, meaning they have sufficient funds, making them less likely to close. Keeping more hospitals open would then contribute to a better quality of life for people, especially in rural communities, by providing them a place to access life-saving treatments and handle medical emergencies. In addition, the Affordable Care Act has increased access to healthcare insurance and treatments for many people. In many health tracking polls, out of all the people that support the act, about 78% said that the act allowed their family to get easier access to health insurance and healthcare treatments(Kirzinger et al., 2022). This would ultimately increase the quality of life for many in the United States since more people are getting the healthcare they need.

The Affordable Care Act has also reduced some gaps in health insurance coverage between races and ethnicities. For example, according to the census, the insurance coverage difference between white and black people was reduced by 4.1% after the implementation of the ACA. Between white and Hispanic populations, this gap was reduced by 9.4 % (Baumgartner, 2020). Overall, this aspect of the Affordable Care Act promotes a better quality of life for Americans since it reduces some discrimination in healthcare insurance coverage and allows marginalized groups to gain more access to healthcare. 

Which Groups Support or Oppose the Affordable Care Act?

Support and opposition to the Affordable Care Act have generally about 87% of the Democrats supporting it, while about 42% of the Republicans generally oppose it. In KFF polls, the Affordable Care Act is supported by 55% of the population(Kirzinger et al., 2022). Overall, this makes the ACA policy slightly more favored by the general public. Disagreements regarding the policy are generally along party lines according to the percentages, but there are still variations in certain parts of the policy. In general, protecting health insurance coverage for people with preexisting conditions is the most popular aspect of the law, with 72% support across all groups.

In contrast, only about 51% of people support adults using their parent's insurance plan until they are 26 years old, making this a more controversial provision of the law(Kirzinger et al., 2022). The National Federation of Independent Businesses opposed the Affordable Care Act. It started a lawsuit against the Department of Health since they were against the provision that told all Americans to get a health insurance program. Ultimately, the Supreme Court upheld the Affordable Care Act, but this group continues to give money to the Republican party in hopes of limiting the Affordable Care Act. Other organizations supported the Affordable Care Act, such as the Pharmaceutical Researchers and Manufacturers of America and the American Medical Association. These organizations influenced the bill by preventing the government from controlling prices for medicines under the Affordable Care Act. This privatization was created to benefit hospitals and medicine manufacturers. Other groups, such as Indivisible and Planned Parenthood, supported the Affordable Care Act and staged protests to prevent Republican lawmakers from creating an alternative healthcare law called the American Health Care Act (McFadden, 2021).

What Are Some Unintended Consequences of the Affordable Care Act?

While the Affordable Care Act has expanded insurance coverage for many people, it has had many unintended consequences. One of these consequences is hospital monopolies, such as St. Luke’s Health System in Idaho or Partners in Health Care in Massachusetts. As a result of more insurance coverage and changes in healthcare prices, smaller hospitals have started combining in order to be able to control prices in the market better. A result of this would also be that there would be one standardized price and would essentially put hospitals not in the monopoly out of business, thereby reducing competition. This market price set by the monopolies would generally be higher, which would ultimately increase some healthcare costs by about 20%, despite the initial intent of the Affordable Care Act to reduce them (Nabi, 2016). This can be backed up by the fact that about 59% of the people hurt by the ACA claim that it increased their healthcare costs (Kirzinger et al., 2022). This implies that the Affordable Care Act falls short in its intent and goal of providing affordable healthcare to all Americans. In addition, the Affordable Care Act has not entirely solved the problem of high healthcare costs in the United States. For example, about 45% of people who do not have insurance say that the main reason they did not get insurance is due to high costs. In addition, in 2021, 1 in 10 Americans had to take irregular doses of medicine to conserve medicine since they could not afford to take the total dose (Thomas, 2022).  This portrays an unintended consequence of the Affordable Care Act since the act intended to reduce healthcare costs. However, a substantial number of people cannot access health insurance solely due to its cost. In addition, the inability to take medicines as prescribed due to high costs can be very detrimental to a person’s long-term health. The Affordable Care Act cannot stop this from happening, which highlights an unintended consequence of the act.

Conclusion

Overall, the Affordable Care Act has helped many people access health insurance at lower costs. This has generally been beneficial to people part of rural and marginalized communities since the act has been influential in reducing the gap in healthcare equity. However, the act has shortcomings, such as the creation of hospital monopolies driving up prices, and many people still need help to afford adequate healthcare in the United States. The debate on the benefits and drawbacks of the Affordable Care Act has divided many groups of people, with the Democrats generally supporting the Affordable Care Act, while Republicans generally oppose it. Ultimately, the Affordable Care Act has succeeded, with more room to improve to expand healthcare equity for all in the coming years. 

References

• 5 Charts About Public Opinion on the Affordable Care Act. (2022, April 14). KFF. https://www.kff.org/health-reform/poll-finding/5-charts-about-public-opinion-on-the-affordable-care-act-and-the-supreme-court/

• 10 Ways the ACA Has Improved Health Care in the Past Decade. (2021, November 2). Center for American Progress. https://www.americanprogress.org/article/10-ways-aca-improved-health-care-past-decade/

• Health Affairs. (n.d.).

• How the Affordable Care Act Has Narrowed Racial and Ethnic Disparities in Access to Health Care. (2020, January 16). https://www.commonwealthfund.org/publications/2020/jan/how-ACA-narrowed-racial-ethnic-disparities-access

• McFadden, A. (2021, June 23). The long, costly battle over Obamacare might be over. OpenSecrets News. https://www.opensecrets.org/news/2021/06/costly-battle-obamacare-over/

• The Affordable Care Act: Lessons learned and unintended consequences. (2016, November 30). The BMJ. https://blogs.bmj.com/bmj/2016/11/16/the-affordable-care-act-lessons-learnt-and-unintended-consequences/

• Thomas, J. (2022, February 28). Opinion: The Affordable Care Act forgot to be affordable. Connecticut Post. https://www.ctpost.com/opinion/article/Opinion-The-Affordable-Care-Act-forgot-to-be-16947851.php