The Trillion Dollar Revolution by Ezekiel J Emanuel & Abbe R. Gluck

Author:Ezekiel J Emanuel & Abbe R. Gluck
Language: eng
Format: epub
Publisher: PublicAffairs
Published: 2020-03-02T16:00:00+00:00

Final Thoughts: Did the ACA Work?

We opened our chapter by posing the question: Did the ACA work? Having highlighted dozens of studies from a large body of research about the law’s coverage expansions, there is no simple answer. If we had to give our best cocktail party reply, we would say, “On the whole, yes. But in some ways, not as well as hoped. And in many ways, it’s still too soon to know.”

Undoubtedly, the ACA succeeded in bringing health insurance coverage to about 20 million Americans who would otherwise be uninsured. On average, those gaining coverage have experienced major improvements in access to affordable care, have obtained more care to treat their acute and chronic conditions, and, by several important measures, are feeling better and perhaps even living longer.

But the ACA fell short of total enrollment targets, expanding coverage to fewer than half of the nation’s uninsured population, and it is possible that some of the law’s early coverage gains are already waning. And the health care that was delivered to newly covered populations might not have produced as much health improvement as it could have. At its 25th anniversary, should the law survive that long, we will have a much clearer sense of which changes implemented by the ACA have stood the test of time and what long-term effects on health care use and health outcomes it has produced. In the meantime researchers will continue working to expand our understanding of the effects of this complex and far-reaching law.

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