Reflection on the Affordable Care Act After a Decade
For over ten years, Americans have been living with the Affordable Care Act (ACA), which President Obama championed with promises of being able to keep plans and doctors, lower premiums, more choices, and protection for those with preexisting conditions. However, many families across the country have experienced a different reality: premiums are still climbing, deductibles have skyrocketed, some unauthorized immigrants are utilizing taxpayer-funded ACA plans, and a surprising number of hardworking individuals continue to face challenges in finding doctors that accept their insurance.
Rather than achieving universal coverage, the ACA has left over 28 million people uninsured, according to the Centers for Disease Control and Prevention. The legislation fails to deliver the affordability and accountability that many Americans expect, which puts pressure on Congress to take action.
Reforming the healthcare system doesn’t mean dismantling it; rather, it involves serious, thoughtful reforms. This process starts with diligent oversight. For years, Congress has allowed insurance companies and pharmacy benefit managers to function without substantial scrutiny, a trend that definitely needs to change. As of 2023, the five largest health insurers’ CEOs are reportedly making about $75 million annually, while the average American family’s premiums have reached nearly $26,000 yearly.
Since the ACA’s inception, taxpayer-funded revenue exceeding $9 trillion has been funneled to these health insurance companies. It’s essential to bring health insurance leaders before Congress to demand clarifications on the continuous rise in costs, especially when those insurers have seen record profits that total nearly $400 billion since the ACA passed.
Routine hearings and audits should be standard practice—not exceptions. It’s important to gain clarity on how healthcare dollars are allocated, pricing decisions made, and why American families are still burdened under a system that doesn’t prioritize patient care. This kind of oversight isn’t about punishing success; instead, it’s about making sure there’s accountability to the public.
Furthermore, accountability must incorporate transparency. Any health insurer that benefits from taxpayer funding—be it through ACA exchanges or subsidized plans—should be mandated to publicly disclose and rationalize proposed rate increases, similar to the requirements placed on public utilities. If public utilities have to justify their price hikes, health insurers enjoying billions in taxpayer support should adhere to the same standards. Rate adjustments that impact countless families should be subject to public examination, rather than hidden away in obscure fine print.
As a physician, I understand that mere congressional oversight won’t mend the issues at hand. We also need to address one of the most persistent yet overlooked contributors to rising costs: lawsuit abuse. Defensive medicine—ordering tests and procedures primarily as a safeguard against lawsuits—places an immense financial burden on healthcare. Implementing a “loser pays” tort reform model could deter frivolous lawsuits, cut unnecessary medical costs, and help stabilize malpractice premiums for doctors, particularly those in rural or high-risk fields. While legitimate claims would still be pursued, there’s no need to reward baseless lawsuits.
At the same time, we should pivot our focus towards encouraging wellness rather than simply funding illness. Chronic illnesses, like diabetes and heart disease, account for a significant chunk of healthcare expenditure. Promoting preventive care, nutrition, fitness, and disease management through tax incentives and community initiatives could reduce long-term costs and enhance Americans’ quality of life. This focus on wellness aligns well with efforts to make our nation healthier and reduces preventable illnesses.
Additionally, we must recognize that trying to extend taxpayer-funded healthcare to unauthorized immigrants inevitably strains the system to its limits, potentially leaving everyone uninsured.
A healthier populace contributes to greater prosperity.
Finally, it’s critical to embrace the latest healthcare technologies. Advances like telehealth, AI-driven diagnostics, and digital health monitoring provide promising avenues to lower costs and increase access. During the pandemic, many Americans, including those in my rural district in Arizona, found that they could manage various appointments through virtual means, which saved both time and money. Congress should capitalize on this momentum by updating antiquated regulations, enhancing rural broadband access, and ensuring insurers fairly reimburse technology-assisted care. The private sector is creating top-tier solutions, and the government should facilitate their widespread adoption.
Reforming the ACA and our broader healthcare system isn’t merely a matter of partisanship; it’s about accountability. American families shouldn’t have to bear another decade of unmet promises from the ACA. They deserve a healthcare system that is transparent, fair, innovative, and affordable. Through solid oversight, responsible legal reform, a focus on wellness, and modern technology, we can build a healthcare system that genuinely serves its people.
Congress needs to take the lead, and the urgent need for reform is now.
