Abstract
This authoritative appraisal of the much debated U.S. Patient Protection and Affordable Care Act, often referred to as Obamacare, describes the controversy, support, and opposition from federal and state governments during the first 5.5 years since the law was passed. Its history, the impact on individual and community health status, the limitations of health reform, its accomplishments and deficiencies, and the impact of societal determinants on program implementation are presented in a refreshing, candid, objective, and knowledgeable manner.
Get full access to this article
View all access options for this article.
References
1.
Freed
GI
Das
A
. Nixon or Obama: who is the real radical liberal on health care? Pediatrics 2015 ; 136 : 211 –214 .
2.DiJulio B, Firth J and Brodie M. Kaiser health tracking poll, http://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-august-2015/ (2015, accessed 20 August 2015) .
3.Cohen RA and Martinez ME. Health insurance coverage: early release of estimates from the National Health Interview Survey, http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201508.pdf (2015, accessed 15 August 2015) .
4.Gallup. In U.S., uninsured rates continue to drop in most states, http://www.gallup.com/poll/184514/uninsured-rates-continue-drop-states.aspx (accessed 17 August 2015) .
5.Garrett B and Kaestner R. Recent evidence on the ACA and employment: has the ACA been a job killer?, http://www.urban.org/sites/default/files/alfresco/publication-pdfs/2000327-Recent-Evidence-on-the-ACA-and-Employment-Has-the-ACA-been-a-Job-Killer.pdf (2015, accessed 17 August 2015) .
6.
Mehta
SJ
Polsky
D
Zhu
J
. ACA-mandated elimination of cost sharing for preventive screening has had limited early impact . Am J Manag Care 2015 ; 21 : 511 –517 .
7.American College of Emergency Physicians. 2015 ACEP poll Affordable Care Act research results, http://newsroom.acep.org/2015-05-04-ER-Visits-Continue-to-Rise-Since-Implementation-of-Affordable-Care-Act (2015, accessed 21 May 2015) .
8.Jacobsen G, Damico A, Neuman T, et al. Medicare advantage 2015 spotlight: enrollment market update, Henry J. Kaiser Family Foundation, http://kff.org/medicare/issue-brief/medicare-advantage-2015-spotlight-enrollment-market-update/ (2015, accessed 8 July 2015) .
9.AHIP Data Brief. Impact of hospital consolidation on health insurance premiums, http://www.ahipcoverage.com/?p=15991 (2015, accessed 13 July 2015) .
10.Town R, Wholey D, Feldman R, et al. The welfare consequences of hospital mergers . National Bureau of Economic Research Working Paper no. 1224, National Bureau of Economic Research, Cambridge, MA, USA, 2006 .
11.
Dafny
L
. Hospital industry consolidation—still more to come? N Engl J Med 2014 ; 370 : 198 –199 .
12.United States Government Accountability Office. Medicaid: overview of key issues facing the program, http://www.gao.gov/assets/680/671238.pdf (2015, accessed 9 July 2015) .
13.United States Government Accountability Office. Medicaid: a small share of enrollees consistently accounted for a large share of expenditures, http://www.gao.gov/assets/680/670112.pdf (2015, accessed 14 August 2015) .
14.National Health Council. Enhancing the patient-centeredness of state health insurance markets state progress reports, http://www.nationalhealthcouncil.org/sites/default/files/Enhancing-State-Health-Insurance-Markets.pdf (2015, accessed 3 August 2015) .
15.Catalyst for Payment Reform and Health Care Incentives Improvement Institute. Report card on state price transparency laws, http://www.hci3.org/sites/default/files/files/2015_Report_PriceTransLaws_06.pdf (2015, accessed 17 August 2015) .
16.Polsky D and Weiner J. The skinny on narrow networks in health insurance marketplace plans, http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2015/rwjf421027 (2015, accessed 9 July 2015) .
17.Rau J. Half of nation’s hospitals fail again to escape Medicare’s readmission penalties, Kaiser Health News, http://khn.org/news/half-of-nations-hospitals-fail-again-to-escape-medicares-readmission-penalties/ (2015, accessed 3 August 2015) .
18.Krawzak PM. Shortcut for budget reconciliation mulled by GOP leaders, CQ roll call, http://www.commonwealthfund.org/publications/newsletters/washington-health-policy-in-review/2015/aug/aug-17-2015/shortcut-for-budget-reconciliation-mulled-by-gop-leaders?omnicid=WHPR854643&mid=thomas@asahp.org (2015, accessed 17 August 2015) .
19.Congressional Budget Office. Budgetary and economic effects of repealing the Affordable Care Act, https://www.cbo.gov/sites/default/files/114th-congress-2015-2016/reports/50252-Effects_of_ACA_Repeal_1.pdf (2015, accessed 4 August 2015) .
20.American Academy of Actuaries. Issue Brief: drivers of 2016 health insurance premium changes, http://actuary.org/files/Drivers_2016_Premiums_080515.pdf (2015, accessed 17 August 2015) .
21.Kutscher B. Fewer hospitals have positive margins as they face financial squeeze, modern healthcare, http://www.modernhealthcare.com/article/20140621/MAGAZINE/306219968/fewer-hospitals-have-positive-margins-as-they-face-financial-squeeze?utm_source=frontpage&utm_medium=newsitem309&utm_campaign=carousel-traffic (2014, accessed 18 August 2015) .
22.Robertson K. Lens into the future: health system CEO interviews, http://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-dchs-health-system-ceos.pdf (2015, accessed 18 August 2015) .
23.Mitts L and Fish-Parcham P. Non-group health insurance: many insured Americans with high out-of-pocket costs forgo needed health care, http://familiesusa.org/sites/default/files/product_documents/ACA_HRMSurvey%20Urban-Report_final_web.pdf (2015, accessed 5 August 2015).n-t .
24.Accenture. Accenture doctors survey 2015, https://www.accenture.com/us-en/insight-2015-healthcare-it-check-up-shows-progress-pain-infographic (2015, accessed 3 August 2015) .
25.
Berwick
D
Bauchner
H
Fontanarosa
PB
. Innovations in health care delivery: call for papers for a yearlong series . JAMA 2015 ; 314 : 675 –676 .
26.
Howell
BL
. Guiding principles for center for Medicare & Medicaid innovation model evaluations . JAMA 2015 ; 313 : 2317 –2318 .
27.Agency for Health Care Research and Quality. Health care innovations exchange, https://innovations.ahrq.gov (2015, accessed 14 August 2015) .