Failures of the Affordable Care Act (ACA) Rising Healthcare Premiums

One of the major criticisms of the Affordable Care Act (ACA) has been the increase in healthcare premiums. The ACA aimed to expand access to affordable healthcare, but many individuals have experienced rising premiums in the individual market (Davidoff et al., 2018). The ACA attempted to address this by introducing subsidies and cost-sharing reductions for low-income individuals, but rising premiums have particularly affected middle-income families. Some reasons for this include the cost of covering individuals with pre-existing conditions and the requirement that insurance companies cover certain essential health benefits. Additionally, the ACA created an age rating system that limits the variation in premiums based on age, which has resulted in younger and healthier individuals paying more to help offset the costs of older and sicker individuals.

Limited Provider Choice

Another issue with the ACA has been the limited provider choice for individuals who purchase insurance through the marketplace. In order to keep costs down, insurance companies have narrowed their networks of healthcare providers, meaning that individuals may not be able to see the doctor of their choice or receive care from certain hospitals (Boone, 2019). This has particularly affected individuals with complex medical conditions who require specialized care. Additionally, some insurers have dropped out of specific marketplaces altogether, leaving individuals with even fewer options for healthcare coverage.

Political Controversy and Division

The ACA has been a source of political controversy and division since its inception. A Democratic-controlled Congress passed the law without any Republican support, which created a sense of animosity toward the law from some Republicans (Grogan & park, 2018). Additionally, the Supreme Court upheld the constitutionality of the ACA in 2012, but there have been numerous attempts to repeal or undermine the law through legal challenges and budget cuts. This has created uncertainty and instability in the healthcare system, making it difficult for individuals and healthcare providers to plan for the future.

Increased Administrative Costs

The ACA has also been criticized for increasing administrative costs in the healthcare system. The law introduced new reporting requirements for insurance companies, hospitals, and other healthcare providers, which has resulted in increased paperwork and administrative burdens (Crowley et al., 2021). Creating new marketplaces and insurance regulations have also required significant resources from both public and private entities. Some critics argue that the administrative costs associated with the ACA have resulted in higher healthcare costs overall.

Inadequate Coverage for Some Individuals

Despite the ACA’s goal of expanding access to healthcare coverage, some individuals still face inadequate coverage. For example, some individuals who purchase insurance through the marketplace may have high deductibles or out-of-pocket costs, making it difficult to afford healthcare services (Hall et al., 2019). Additionally, the ACA did not address the issue of healthcare access in states that chose not to expand Medicaid eligibility, leaving many low-income individuals without access to affordable healthcare coverage. The ACA also did not address the issue of healthcare access for undocumented immigrants, who are not eligible for marketplace coverage or Medicaid.

Conclusion

In conclusion, the ethical and legal aspects of healthcare reform, specifically the dismantling of the Affordable Care Act, have been a source of significant debate and concern. The ACA’s ten essential benefits guarantee that individuals can access essential healthcare services, such as emergency care, prescription drugs, and mental health services. While the ACA has had its successes, such as increasing access to healthcare and improving health outcomes, it has also faced criticism for its high cost and limited consumer options. The ongoing debate over healthcare reform highlights the complex interplay between ethics, law, and policy in the healthcare system. As healthcare evolves, it is essential to consider the ethical implications of policy decisions and their impact on patients’ health and well-being.