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Unpacked

Replacing the Affordable Care Act

Stuart M Butler
Editor's Note:

In Unpacked, Brookings experts provide analysis of Trump administration policies and news.

THE ISSUE: As Congress considers the new House Republican-backed replacement for the Affordable Care Act (ACA), they must ensure that it accomplishes a set of specific goals that are crucial for providing broad, affordable coverage to U.S. citizens.

The ability to evolve has to be a key part of the ACA replacement.

THE THINGS YOU NEED TO KNOW

  • People who were uninsurable prior to the ACA need to receive coverage under a new plan.
  • Coverage needs to be affordable so that people can visit a doctor without feeling that they will be unable to pay the deductibles or copayments.
  • There has to be a system of subsidies so that people with a variety of medical histories and incomes can afford coverage.
  • The market must be stable; insurers need to see that there is an opportunity to make an adequate return by covering a diverse set of people under the new plan.
  • Providing health care is very expensive, a new plan must allocate enough expenditure.
  • It will be difficult to form an effective replacement plan if spending is reduced or if taxes like those under the ACA are eliminated but not replaced with another source of revenue.
  • A replacement plan must be able to adapt to constantly changing conditions in the insurance market.
  • States should have considerable opportunities for experimentation in how they organize insurance and how they distribute subsidies to citizens.

THE SOURCES

Moving to the next phase of health care reform

Why repealing the ACA before replacing it won’t work, and what might

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