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Key Findings

1. The sweeping Affordable Care Act (ACA) has not come close to reaching its supporters’ promised goals of providing universal health insurance coverage and decreasing ever-rising health care costs.
    
2. Congress has been unable to act to reform and improve the U.S. health care system.
    
3. The Trump Administration has taken a number of actions outside of the ACA in an effort to hold down costs and increase access to health care:
   • Discontinued the unauthorized cost-sharing reduction payments.
   • Extended the use of short-term, limited-duration plans.
   • Eliminated cost-reduction subsidies.
   • Encouraged association health plans.
   • Reduced funding for navigators and advertising
   •  Improved the economy, leading to more employers providing health benefits.
      
4. In addition to executive-order changes, the ACA contains two broad areas that are open to Administrative interpretation. These are Section 1332 state waivers and Section 1115A state Medicaid waivers.
    
5. States, either through legislation or the waiver process, have been active in attempting to decrease health care costs and improve health care access for their residents.
    
6. This policy trend has produced positive results for citizens, and is achieving one of the long-sought goals of national health care policy – making quality coverage more affordable for everyone.
    

Introduction

 The controversial Affordable Care Act (ACA), also known as Obamacare, has helped some people gain health care coverage. The tragedy is that the sweeping federal law has not come close to reaching its supporters’ promised goals of providing universal health insurance coverage and decreasing ever-rising health care costs. 

The complex law has not improved health care quality and has not provided patients with more health care choices. It has, unfortunately, forced millions of people to lose health coverage that they liked, and be forced to seek new health insurance while imposing a huge financial and regulatory burden on the vast majority of Americans. 

This study describes and analyzes the federal and state administrative changes that have been made so far in the Obamacare program. This is an update to our major study released in January 2018.

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Click here to read the original study