The Affordable Care Act had three main priorities: to improve access to health care, control the growing cost of health care spending and improve the quality of services delivered to Americans. Prior to the Affordable Care Act, our system was broken – family premiums for employer coverage doubled over ten years, and in 2009, health spending reached nearly 18 percent of the gross domestic product. Finally, the United States lagged behind other similar countries on infant mortality, obesity and hospital-acquired infections.
As a practicing physician and a policy researcher, I can say that improvements in all three key priority areas are really happening. One of my newest patients is a 52-year-old woman with progressively debilitating shortness of breath. She was working two part-time jobs as a waitress, and could not previously afford health insurance until the Affordable Care Act. I found out she had undiagnosed heart disease, which we were able to diagnose and treat. I am also making sure that she receives other important preventive services, such as breast cancer detection and immunizations. Her quality of life was improved dramatically in a matter of weeks, thanks in large part to the the health care law.
But it’s not just stories from doctors’ offices – we are seeing signs of success across the country.
Improving Access: In the state of Kentucky, 75 percent of individuals who enrolled in the Affordable Care Act last year said that it was the first time they had health insurance. Technical glitches and all, the state of California was able reduce its rate of uninsured persons in half, from 22 percent to 11 percent. This year, California has opened storefronts to help people enroll and is targeting difficult-to-reach populations through additional efforts.
Controlling Costs: Growth in health spending over the past four years has been the slowest rate on record in approximately 50 years. There is a great deal of disagreement on the reasons for the slowdown (e.g., the recession, health system reforms, the Affordable Care Act), but aspects of the health care law are working to improve costs for consumers. New models of care that improve coordination of care – from the primary care doctor’s office to the emergency room – and reduce waste within the system are beginning to take hold in communities throughout the country. Patients also now have more resources and tools that support transparency in pricing and quality of providers, which can help them save money on procedures without compromising safety or effectiveness.
Improving Quality: In a short time, efforts to improve our nation’s quality of care have also yielded success. For example, rates of Ventilator-associated pneumonia (a condition which is considered avoidable) have decreased 55.3 percent from 2010 to 2012, and the rate of dangerous blood clots during hospitalization have dropped 12 percent during the same time period.
Are there improvements to be made to the Affordable Care Act? Definitely. Will there be aspects of the law that are imperfect and frustrating? Absolutely.
But it is working, and should continue to be allowed to improve the health of our nation. For historical perspective, when the Medicaid program was implemented in 1966, only six states signed up initially. The last state to adopt the program was Arizona in 1982. Large-scale policy changes are complex and can be confusing. To ensure that the Affordable Care Act is improving lives, we should collectively focus on how to encourage more conversations about health care and how to build on the law’s three main priorities.