Affordable Care Act (ACA)



The Affordable Care Act (ACA) is a policy that was enacted under the leadership of President Barack Obama of the United States of America. With its nickname, “Obama Care”, the Act was designated for numerous reasons that include, making health care and health insurance affordable and to reduce the number of uninsured Americans. Improving health care performance and system outcomes is also a reason for its enactment. For several years, the government has had numerous failed attempts to amend the medical care structure within the United States for purposes of improving health care. The failed attempts are identified with President Clinton’s efforts registered since 1993. However, there have been several policies and programs at the federal level successfully registered. These programs and policies aimed at controlling costs associated with Medicare and Medicaid and were successfully implemented at both federal and state levels though still characterized by significant challenges (FitzGerald, Bias & Calvez, 2017). The essay below discusses the Affordable Care Act and its contribution healthcare delivery, economic and or policy aspects associated with it, stakeholders of the act and the roles they each play in its operationalization. Also, ways of addressing health care issues and the impact of the Act on future health care have been examined.

Affordable Care Act as it relates to health care delivery, economics, and policy

The care Act was initiated to enhance health care services to everyone, lowering of costs and patient protection. The state of Massachusetts with regards to the ACA approved three influencing legislation of health care from 1998 to 2006 including the extension of benefits of Medicaid to high-income earners. These were seen as a basis of reforms for several federal elements of the ACA. The debates on ACA were heralded by numerous endeavors to extend the coverage of healthcare insurance in the previous century. In the year 1912 with its continuation all through the 20th and 21st century, several American presidents, for instance, Theodore Roosevelt and former President Bill Clinton were unsuccessful in this quest. The non-accomplishment of the implementation of a national medical insurance scheme except for President L. Johnson signifies the efforts. In the 1960’s, there was a successful enactment of a medical insurance structure for elderly and disabled Americans called Medicare and the State Children’s Health Insurance Program in 1997. The law provided infants with insurance whose families earned modest incomes. The coverage for drug prescriptions was also extended for seniors in 2003 (Stack, 2015). Consequently, the implementation of the ACA has improved the labor market by putting more money in the pockets of the citizens through providing insurance services cover that addresses their health needs. The act also provided reforms to Medicare that reduced the excessive payments imposed on private insurers and medical providers. The reforms led to slow growth in health care costs thus laying a foundation for future economic growth. 

The stakeholders of the Affordable Care Act and their roles

The main stakeholders in the ACA are departments of health, different federal departments, health department partners, the private segment and public humanitarian organizations. These particularly include patients, government, physicians and the general community.

Civil Society Organizations (CSO), the policies implemented by World Bank, for instance, extending monetary aid to achieve health goals. The World Bank collaborates with distinct institutions for example Global Fund that aims to fight illnesses such as tuberculosis, malaria, and AIDS. The others are medicine alliance, monetary intermediate funds so as to expand medical institutions. 

The private segment, organizations that receive funding from well-wishers and international organization are participating by essentially providing medical care to patients. These organizations with their help have over time improved provision of healthcare through offering medical support to people in far areas and slums affording them medical services.


The major role of physicians is to ensure that their patients receive adequate health care services and institute controls over the high costs of healthcare services and affiliated products. The physicians have to ensure their patients are receiving adequate health care and manage the costs of the insurance companies. 

Health department partners

These provide extended monetary help together with the practical support of medical health facilities to recipients in various locations. An example is the Pakistan democratic health survey in 2013 (PDHS) and expansion of maternal newborn and child health, and provision of family planning products.

How the ACA is addressing health issues within the health sector

The Affordable Care Act in its attempt to improve the healthcare of people in the United States uses elements such as providing no-cost preventive services, linking other physician and healthcare performance to pay for the health services (Medicare) starting from 2015 and increasing medical transparency by reducing the price of products and services. Subsidizing small businesses to help them in the provision of health insurance benefits and exempting middle-class families from paying tax (FitzGerald, Bias & Calvez, 2017).

The elements used by ACA aim at supplementing the acquisition of health insurance in federally-operated or state marketplace. All these elements were to lower costs and improve the medical care quality. On the other hand, increasing competitiveness of insurance offerings in health, marketplaces for health insurance have been created thereby increasing quality and affordability. The intention of extension of Medicaid was to cover for the less privileged which is the working poor that constitutes 100% to 133% of the poverty level.

The last element is the increase in reimbursements of health care providers in rural places that encourage health professionals to stay in Poor and distant communities. Under the New Patients’ Bill of Rights, there has been an establishment of many consumer protections. There are common consumer protection sections that are disallowing pre-existing conditions, lifetime limits on the coverage of insurance and withdrawing insurance coverage when the insured person becomes ill. Finally, granting the insurer an appeal when denied the coverage. The major objectives of the ACA were aimed at increasing and improving healthcare through affordability and enhanced access to health services besides ensuring all parties seeking the services obtain high-quality health care (Cooper & Gardner, 2016).

The ACA policy established an extensive number of changes that are currently imposed on private health insurance. The reforms include affordability of the coverage, quality of the coverage and improving access to health insurance. The reforms targeting access include renewability and guaranteed issue, insurance exchanges creation, the CO-OP program creation, dependent coverage age extension and the individual mandate. Those addressing affordability are guidelines that constitute fair health insurance premiums, prohibited rating factors, reductions in cost-sharing and premium tax credits. 

Essential creation of benefits associated with health packages, the maximums of out of pocket payments, removal of annual and lifetime limits, removing the cost-sharing for the benefits of prevention, tying the options of designation and value-sharing of corresponding requirements and competent health strategies are among the many other ways the ACA has addressed issues associated with healthcare in the United States.

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The intended impact of the Affordable Care Act on future healthcare

The future of healthcare service delivery covers the inclusion of all and possibilities of all people equally accessing healthcare. The rapid changes in technology, especially in the healthcare front, rely on this Act among other pieces of legislation. The possibilities of a further reduced number of the uninsured also feature as a future benefit of this Act. Improving the expectations of the populations while supporting demographic alterations will foster positive attributes. Also, the possibilities of cutting on the government spending on healthcare are featured as discussed by Davis, (2017) that $834 billion would be saved from the Medicaid program with the ACA in place.

On the contrary, the ACA has advanced challenges to the healthcare system. These challenges range from the difficulties or the inability of some percentages of the populations to afford health insurance despite the presentation of subsidies by the system. The unaffordability of the out of pocket costs presents another challenge. Additionally, prescription of drug spending is on a progressive rise inflating the entire healthcare budget and spending of the populations. The difficulties of the insurance platforms to attract healthier and younger participants with possibilities and abilities to offset the insurance coverage costs for the less healthy and elderly people are another failure worth noting. According to the 2014 expansion in the policy, there has been an improvement in the health insurance coverage than it was in 2011. 

These patterns are reliable with the remark that the sole reason given by people that were not covered by the health insurance before the passing of the ACA was very expensive (Glied & Jackson, 2017). The future of the Affordable Care Act is going to be characterized by many companies offering more policy options in the health insurance coverage with lower premiums and fewer benefits. On the other hand, the Medicaid is a federal-state program that will continually help with the provision of health care to the elderly, needy and the disabled hence, improving their health status. As previously witnessed from the separate health care reform, those in-charge of both Medicaid and Medicare services together with the department of health and human services in the US have shown willingness enabling States to change terms of eligibility for Medicaid patients. Improving the Health Department by training the labor force, infrastructural improvement as well as improving administration and governance capabilities will enhance the generation of successful results on health (Boland et al., 2012).  


In summary, it is seen that the enactment of the ACA also contributed positively to improving the health of the needy, young, elderly and the disabled people in the United States.  The major contributions of ACA include improving access to health facilities, providing a market where insurance coverage can be purchased cheaply and reducing costs of medical services through Medicare and ACA and Medicaid programs. On the other hand, the key stakeholders of ACA are the Department of Health, health development partners, the private sector and civil society organizations that have all provided support to the Act. The future impacts of ACA are seen in the increasing number of developments and changes in the healthcare system which might affect the delivery of healthcare services either positively or negatively in the future.

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  1. Boland, P., Simone, P., Slutsker, L., De Cork M, D. (2012). The Role of Public Health Institutions in Global Health System Strengthening Efforts, 1-8.
  2. Cooper, W.R. & Gardner, A.L. (2016). Extensive Changes And Major Challenges Encountered In Health Insurance Markets Under The Affordable Care Act. Journal of Financial Service Professionals, Vol, 70(5), 53-71.
  3. Davis, J. (2017). Health Care Reform Is Just Warming Up. Physician Leadership Journal, 10-13.
  4. FitzGerald, P.M., Bias, T. & Calvez, G.T. (2017). The Affordable Care Act Well-Being: Known and Unknowns. The Journal of Consumer Affairs, Vol 51(1), 27-52.
  5. Glied, S. & Jackson, A. (2017). The Future of the Affordable Care Act and Insurance Coverage. American Journal of Public Health, Vol 107(4), 538-540.
  6. Stack, J.S. (2015). Health Care Reform in the United States: Past, Present and Future Challenges. World Medical Journal, 153-157.
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