What’s Next for the ACA and the People It Covers?


If Republicans are unable to revive last week’s failed effort to repeal and replace the Affordable Care Act (ACA), the nation will need to turn back to ensuring the long-term success of the law. Decisions made by the Trump administration and Congress as well as state policymakers over the next few years will help determine how many people the ACA covers, how affordable the coverage is, and its cost to federal and state governments. Such decisions include whether and how the administration will use its executive authority to sustain, or undermine, the law’s key provisions, and how Congress might ensure the stability of individual health insurance markets nationwide.

Policymakers will need to keep in mind what’s at stake: the health and well-being of real people with real health care problems. The ACA has enabled more than 30 million Americans to get health insurance or to purchase more valuable coverage. Provisions of the law aimed at improving the delivery system have reduced the number of people treated in hospitals who have to be readmitted for more care, and have contributed to a slowdown in the rate of growth in health care costs. As elected and executive branch officials contemplate their choices, they should consider these human benefits—and the consequences of jeopardizing them.


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