The Affordable Care Act: Moving Forward in the Coming Years

JAMA. Published online November 28, 2016, DOI: 10.1001/jama.2016.18908

University of Illinois College of Law Legal Studies Research Paper No. 17-07

Posted: 14 Dec 2016 Last revised: 20 Dec 2016

See all articles by Lawrence O. Gostin

Lawrence O. Gostin

Georgetown University - Law Center - O'Neill Institute for National and Global Health Law

David A. Hyman

Georgetown University Law Center

Peter D. Jacobson

University of Michigan School of Public Health

Date Written: November 28, 2016

Abstract

President Barack Obama signed the Affordable Care Act (ACA) in 2010 with no Republican support. The ACA has been politically divisive ever since, with the House repeatedly voting for repeal. Earlier this year, Congress successfully passed a repeal, with the Senate using a legislative process called “reconciliation,” which requires only a simple majority for certain tax and spending bills. However, Congress failed to override a presidential veto.

President-elect Donald Trump pledged to “repeal and replace” the ACA, but would keep the most popular features: (1) guaranteed issue — health plans must enroll applicants regardless of pre-existing conditions; and (2) dependent coverage — health plans must keep dependent children on their parents plan until age 26. Although his reform package has not been announced, it will likely include health savings accounts (HSAs), cross-border insurance sales, Medicaid block grants to states, and a cap on non-economic damages.

In this Viewpoint, we examine potential reforms of the ACA through the lens of empirical evidence to find whether they are likely to be effective, particularly in ensuring access to health insurance at a reasonable cost, and in a stable insurance market. We conclude that the public has a right to expect their representatives to find common ground and adopt evidence-based policies that expand coverage at a reasonable cost.

JEL Classification: I11, I13, I18, K32

Suggested Citation

Gostin, Lawrence O. and Hyman, David A. and Jacobson, Peter D., The Affordable Care Act: Moving Forward in the Coming Years (November 28, 2016). JAMA. Published online November 28, 2016, DOI: 10.1001/jama.2016.18908; University of Illinois College of Law Legal Studies Research Paper No. 17-07. Available at SSRN: https://ssrn.com/abstract=2881549

Lawrence O. Gostin (Contact Author)

Georgetown University - Law Center - O'Neill Institute for National and Global Health Law ( email )

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Washington, DC 20001
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202-662-9038 (Phone)
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David A. Hyman

Georgetown University Law Center ( email )

600 New Jersey Avenue, NW
Washington, DC 20001
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Peter D. Jacobson

University of Michigan School of Public Health ( email )

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Ann Arbor, MI 48109-2029
United States
734-936-0928 (Phone)
734-764-4338 (Fax)

HOME PAGE: http://www.sph.umich.edu/~pdj/

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