What is it about?
The Patient Protection and Affordable Care Act of 2010 (ACA), also known as Obamacare, is at the center of U.S. policy debates. It is complex legislation that deeply impacts the lives of most Americans, yet is poorly understood by most, perhaps including some who seek to repeal and/or replace it. This manuscript describes the complex law and the proposed reforms in a reader-friendly way and also discusses components that are outside the law and likely to remain even if the Affordable Care Act is modified or repealed.
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Why is it important?
An array of "repeal and replace" proposals are being considered by the U.S. Congress, driven by Republican campaign promises, including those of President Donald J. Trump. Yet, the many dimensions and interconnected nature of the provisions of the law are poorly understood by many. This makes it difficult for people to evaluate options and participate in the political process as informed citizens. This manuscript prepares readers to not only understand Obamacare, but also evaluate emerging proposals and their potential impacts.
Perspectives
As an expert in health and payment reform, I am frequently asked for a complete and straightforward, yet not simplistic, overview of the Affordable Care Act. This manuscript is my response to that request. The Act is best understood and, therefore described, by its constituent parts: insurance coverage, transparency, and reimbursement reform. Reforms catalyzed by the Act, although not formally a part of it, are also described. These include items such as the Quality Payment Program under MACRA and delivery reforms like Accountable Care Organizations and Patient Centered Medical Homes, which are also important to understand because they will likely continue even if the ACA is repealed, replaced, or reformed. Readers will develop a firm grasp of all these issues, supporting their informed involvement in policy formation, participation in organizational leadership, and understanding of the impact of proposed reforms to their own health and healthcare.
Betty Rambur
University of Rhode Island
Read the Original
This page is a summary of: What’s at Stake in U.S. Health Reform: A Guide to the Affordable Care Act and Value-Based Care, Policy Politics & Nursing Practice, May 2017, SAGE Publications,
DOI: 10.1177/1527154417720935.
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