ACA anniversary — let’s work to strengthen it, not throw it out

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This week marks the ninth anniversary of the passage of the Affordable Care Act (ACA), a landmark piece of legislation which has extended coverage to over 20 million Americans.

As the debate over America’s health-care future continues to make headlines, now is a critical moment to reflect on the progress we have made and continue working together to extend quality, affordable health care to millions more Americans.

{mosads}Today, more Americans are covered than at any time in U.S. history, an achievement accomplished through the strong partnership between the free market and public programs. Since the passage of the ACA, employer-based coverage has also increased and more than 180 million Americans now receive health insurance through their employers.

As Kaiser Family Foundation CEO Drew Altman recently noted, “[a]bout seven million more people gained employer coverage between 2013 and 2017 — nearly as many as the 10 million people who were covered through the Affordable Care Act’s marketplace last year.”

Through the marketplace exchanges, Americans who are not covered through their employer have access to a variety of options fit to meet their individual needs. And through Medicaid, nearly 12 million Americans gained access to coverage in 37 states and the District of Columbia, which have expanded the program between 2013 and 2017.

In addition to the significant increase in the number of Americans who are covered, Americans are strongly supportive of the ACA’s patient protections — including for those with pre-existing conditions — and other popular features like allowing young adults to stay on their parents’ health plans until they are 26 years old.

While there has been progress, there is still more that can and must be done to expand access to affordable coverage to every American. Thankfully, the current system provides us with the tools needed to achieve this.

One important step would be expanding Medicaid in the remaining states who have not yet expanded the program. This alone would increase access to millions of Americans. Another would be to expand available federal subsidies, allowing all Americans of all income levels to choose market-based coverage that fits their needs. Additionally, we can stabilize premiums to control health-care costs by using tools such as reinsurance.

These are just some of the concrete steps lawmakers can take through our current system and towards the goal of universal coverage, rather than scrapping our entire health-care system, as some have proposed, for a one-size-fits-all government-run program that would cost trillions in higher taxes, eliminate patient choice and control, and throw Americans off their current plans despite the vast majority being satisfied.

Whether it’s called Medicare for All, Medicare buy-in or single payer, such proposals would dramatically reduce the amounts paid to doctors and hospitals, resulting in health care providers being forced to limit the care they provide. For patients this would mean fewer choices and options as they are forced away from their current coverage, plus longer wait times and a lower quality of care as doctors and hospitals struggle to provide care in the face of dramatic cuts to their resources.

Medicare for all would also come at a steep cost to American families, with two independent studies estimating the expense at $32 trillion over ten years — a price tag the Committee for a Responsible Federal Budget found would increase federal spending by 60 percent and require the equivalent of tripling payroll taxes or more than doubling all other taxes. To state the obvious, Americans can’t afford that, and they don’t support it.

Recent polling indicates that most Americans, including most Democratic voters, would rather lawmakers work to enhance our current system by protecting and strengthening what’s working. This tracks closely with what Americans supported at the ballot box last November, when voters in swing districts throughout the nation elected candidates who promised to strengthen our current system — not eliminate it and start from scratch with a one-size-fits-all program.

The fact is, our current system is working for millions of Americans. As we commemorate the ninth anniversary of the Affordable Care Act, lawmakers should reflect on the progress we have made, and continue to protect and build upon what’s working, while coming together to fix what isn’t. 

Lauren Crawford Shaver is the executive director of the Partnership for America’s Health Care Future. She was previously the deputy assistant secretary for public affairs in health care at the U.S. Department of Health and Human Services and has worked on numerous Democratic political campaigns over the last decade.


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