ACA Healthcare Impact

ACA Healthcare Impact

Evaluate the three aims of access, cost, and quality in the US healthcare system. (CLOs 4) (20 Points)

The United States’ health care delivery system has a triad of aims related to access, cost, and quality of care. Evaluate the extent to which the Affordable Care Act (ACA) has achieved the primary aims of enabling its population–approximately 320 million people–to receive health services when needed, while simultaneously containing costs and assuring that health services meet standards of quality.

To prepare for this discussion, please reflect on the learning resources and the media below, as well as your personal and/or professional experiences you have had with health care delivery in the United States and answer the questions that follows:

• US healthcare Delivery System      – HTML
• • How       has the provisions of ACA changed the U.S. health care delivery and       access to care? Be specific about the provision(s) that you are       discussing – explain the provision(s) and the effects.
  • In       your discussion, address why is it that despite public and private health       insurance programs, some U.S. residents are without health care coverage?
  • What       are some of the effects of not having health insurance on personal and       national levels.
  • Identify       possible approaches to improve population health and address health       inequities.As you      form your ideas, consider:
  • Your       initial Discussion Board posts  should be at minimum 250       words.  You are expected to conduct independent research on the       subject and use two scholarly sources in addition to the textbook.       Provide in-text citations and list of references to support your post as       required.

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APA

ACA Healthcare Impact

The U.S. healthcare system aims to balance access, cost, and quality—a triad often referred to as the “iron triangle” of healthcare. The Affordable Care Act (ACA), enacted in 2010, was a major reform effort aimed at improving all three areas. One of its core achievements was expanding access through the individual mandate, Medicaid expansion, and the creation of health insurance marketplaces. These provisions led to a substantial drop in the uninsured rate, particularly among low-income adults and people of color (Courtemanche et al., 2020). The Medicaid expansion, adopted by 39 states as of 2024, played a significant role in improving access to preventive care and chronic disease management.

However, cost containment remains a challenge. While the ACA introduced cost-saving measures such as the Medicare Shared Savings Program and penalties for hospital readmissions, U.S. healthcare costs continue to be among the highest in the world (Tikkanen & Abrams, 2020). Drug prices, administrative overhead, and provider charges remain significant contributors to rising costs. The ACA’s cost control mechanisms have had modest success, but more systemic reforms may be necessary. ACA Healthcare Impact

On the quality front, the ACA emphasized value-based care, incentivizing providers to focus on outcomes rather than volume of services. Programs like the Hospital Value-Based Purchasing Program link Medicare payments to performance on quality measures. As a result, some improvements in patient safety and care coordination have been noted.

Despite these efforts, millions remain uninsured due to factors such as ineligibility for Medicaid in non-expansion states, affordability gaps, or immigration status. The lack of insurance correlates with delayed care, worse health outcomes, and higher emergency room usage, which also imposes economic burdens on the system (Garfield et al., 2021).

To further improve population health and reduce inequities, policy strategies could include expanding Medicaid in all states, enhancing subsidies for marketplace plans, and addressing social determinants of health. Holistic approaches that integrate healthcare with housing, education, and income support are essential to achieving true equity.

References

Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2020). The ACA’s effects on health insurance coverage and labor market outcomes. Health Services Research, 55(S1), 125–136. https://doi.org/10.1111/1475-6773.13221

Tikkanen, R., & Abrams, M. K. (2020). U.S. health care from a global perspective, 2019: Higher spending, worse outcomes? The Commonwealth Fund. https://doi.org/10.26099/7avy-fc29

Garfield, R., Orgera, K., & Damico, A. (2021). The coverage gap: Uninsured poor adults in states that do not expand Medicaid. KFF. https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/