Since it was signed into law in 2010, the Patient Protection and Affordable Care Act has been a source of a tremendous amount of controversy, misconception, and opposition. This has occurred despite the fact that it has long been a goal in the United States to provide all citizens with health insurance. Nevertheless, the ACA, also known as “Obamacare,” is an extremely complex piece of legislation that will likely take years to decipher as well as to understand its consequences. This paper will discuss the purpose, history, and the key provisions of the ACA, in addition to evaluating its effectiveness.

When Barack Obama was running for president in 2008, a cornerstone of his campaign was his proposal for the “largest middle-class tax cut for healthcare in history” (Affordable Health Care Act History, 2015.) However, the idea of creating a national health insurance system had been an unsuccessful goal by Republican and Democratic presidents alike for more than 75 years. Every American president since the end of World War II has tried to make changes in the health care system, some of which have been successful and others which have failed. The main focus of the ACA is to provide health insurance coverage to the millions of Americans who were previously without insurance, in an effort to both improve the health of these citizens as well as to decrease costs of treating the uninsured in emergency rooms that have been passed onto taxpayers.

The Affordable Care Act is an excellent example of the way that ad hoc legislation is implemented, the ways in which it differs from traditional legislating, and the way it affects legislative history. The goal of the ACA has been to provide health care coverage for all American citizens, and its successful passage is likely to dramatically change the enormous health care system in the US as well as becoming one of the most profound pieces of legislation in American history (Cannan, 2013.) There was a long and contentious debate over the ACA from its inception, and in order to enact it there were a variety of ad hoc procedures that were required. A significant indication that the Affordable Care Act did not fit into the typical model of legislation is clear from the fact that it is not one single health care bill that became law, but rather two separate bills. The ACA is comprised of the Patient Protection and Affordable Care Act of 2010, and the Health Care and Education Reconciliation Act of 2010 that was passed almost immediately afterwards to amend the original bill (Cannan, 2013.) After the ACA was signed into law in 2010, the U.S. Congress voted to repeal the Act more than 50 times, but the final hurdle was eliminated in June, 2012, when the Supreme Court upheld most provisions of the law (Affordable Health Care Act History, 2015.)

The purpose of the Affordable Care Act is to guarantee that all Americans have access to affordable health insurance (Bihari, 2014.) The means by which the ACA was designed to accomplish this goal was to significantly lessen obstacles for receiving health coverage in addition to accessing necessary healthcare treatment. The ACA prevents health plans from denying coverage to people because of pre-existing conditions, and also prevents them from dropping the coverage of people who are ill or who become sick. In addition, the reform prevents health plans from charging higher premiums to people who have health issues (About the Law, 2014.) The ACA mandates that large employers offer health insurance to its employees, and subjects employers who do not comply to possible penalties. Small businesses are encouraged to provide insurance plans to employees by offering them tax credits. One of the most controversial provisions of the ACA is the requirement that individuals purchase health insurance or pay a penalty. Finally, the ACA permits parents to keep their children on their insurance plans up to the age of 26 (About the Law, 2014.)

Media coverage of the ACA has varied widely, especially immediately after its passage and implementation, and has contained horror stories about people having to give up their bare-bones plans in favor of much more expensive coverage and copayments. The way the ACA was covered by the media had the effect of frightening many people about its provisions, and hardened the opposition to it on the basis that it represented socialism, higher costs, and government control into people’s lives. However, reports by government agencies about the implementation of the ACA have indicated that in states that have set up health exchanges, such as Kentucky, there has been tremendous success in providing affordable health care to people, especially those who never had healthcare prior to the ACA.

I personally believe that the ACA is a tremendous step forward in the area of providing health care to the uninsured, but I believe that it does not go far enough in terms of providing patient protections. In my opinion, a single payer system would have been ideal, one that resembles the type of healthcare provided in many European countries as well as Canada and Australia. The worst thing about the ACA is that it continues to pour tremendous amounts of money into the pockets of the health insurance industry, and it does not include the ability of the government to negotiate prices for medications, which is a significant drawback. My sense is that the pharmaceutical industry dominates the economic life of the US, and the ACA had an excellent opportunity to help lower the prices of drugs needed by the American public. I have formulated these opinions based on paying close attention to the print media coverage of the ACA rather than the television media, which has tended to be alarmist and provocative in terms of forecasting doom. In fact, my own congressional representative has contacted me several times, soliciting negative stories about the impact of the ACA on my health insurance.

The ACA has slowed the growth of health insurance premiums, although they have not been appreciably lower for people. There is no question that the Act has been of great benefit to people who previously did not have insurance, and indirectly that benefits the American public in general because we have all been covering the cost of emergency room visits by the uninsured. I believe that the biggest impact of the ACA on our healthcare system is the provision of health care to the uninsured in the ability of consumers to shop for health insurance plans that meet their needs. The ACA has not significantly lowered costs of healthcare, but it has slowed the growth to some degree, which is positive. In my opinion, the most positive impact of the ACA on the healthcare system would be if a single payer system would be adopted in the future, which would have the potential to cut into the tremendous profits made by insurance companies, which continue to thrive.