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The Affordable Care Act – Achievements, Challenges, and Future Improvements

The Affordable Care Act – Achievements, Challenges, and Future Improvements

The Affordable Care Act (ACA), widely known as Obamacare, stands as a landmark in the United States’ healthcare history. Enacted in 2010, it aimed to address the intricate issues of healthcare accessibility, affordability, and quality. This essay offers an in-depth exploration of the ACA, focusing on its core objectives, operational mechanisms, accomplishments, limitations, and potential areas for enhancement.

Core Objectives and Mechanisms

The ACA was meticulously designed with several overarching objectives. Its foremost goal was to expand access to healthcare coverage for millions of uninsured Americans. A number of initiatives were used to accomplish this, such as the extension of Medicaid, the establishment of Health Insurance Marketplaces, and the ban on insurance companies refusing coverage due to pre-existing conditions (Meltzer, 2011). Additionally, the ACA introduced the individual mandate, which mandated that most Americans acquire health insurance or face financial penalties. In addition to bolstering healthcare access, the ACA aimed to enhance the quality of healthcare. It introduced measures to elevate the quality of healthcare services offered by providers, encouraging cost-saving strategies through the establishment of accountable care organizations (Anderson & Griffith, 2021). The ACA also sought to improve healthcare affordability for low-income individuals by providing subsidies and tax credits.

Achievements and Impact of the ACA

The ACA has achieved remarkable progress, particularly in reducing the rate of uninsured individuals in the United States. Before its implementation, millions of Americans lacked health insurance, a situation that dramatically improved after the ACA’s enactment. Low-income individuals and families have reaped substantial benefits from the ACA, thanks to the Medicaid expansion and subsidies provided for insurance purchased through the Health Insurance Marketplaces (Bullinger & Meinhofer, 2021).

Consequently, the ACA introduced policies to protect individuals with pre-existing conditions, removing the power of insurance companies to deny them coverage. Young adults also gained extended coverage under their parents’ insurance plans until age 26. These achievements have significantly enhanced the healthcare security of vulnerable and underserved populations, leading to better health outcomes.

Failures and Challenges of the ACA

The ACA is not without its criticisms and failures. One significant challenge is the persistent issue of rising healthcare costs. Despite attempts to curb costs, healthcare expenses have continued to increase, resulting in higher insurance premiums and out-of-pocket expenses for some individuals (Sonfield & Pollack, 2013). Critics have also pointed to the existence of narrow networks in some ACA plans, limiting choices of healthcare providers for certain patients (Lexchin, 2017). Consequently, the individual mandate, a core component of the ACA, faced legal challenges and was effectively repealed in 2019. This removal eliminated a mechanism designed to ensure broad participation in the healthcare system. Additionally, opposition from some states has led to variations in the implementation of the ACA, with some states not expanding Medicaid, thereby limiting access to care for some low-income individuals.


This essay provides an in-depth and comprehensive examination of the Affordable Care Act, shining a spotlight on its noteworthy accomplishments, persistent challenges, and promising avenues for further enhancements. The ACA’s relentless pursuit of accessible, affordable, and high-quality healthcare in the United States is an ongoing journey marked by the potential for future reforms and advancements in the healthcare landscape. This dynamic trajectory underscores the significance of continued efforts to fine-tune and improve the ACA to ensure that it serves as a foundation for a healthier, more equitable healthcare system in the nation.


Anderson, D. M., & Griffith, K. N. (2021). Increasing insurance choices in the Affordable Care Act marketplaces, 2018–21. Health Affairs, 40(11), 1706–1712.

Bullinger, L. R., & Meinhofer, A. (2021). The Affordable Care Act increased Medicaid coverage among former Foster Youth. Health Affairs, 40(9), 1430–1439.

Gorin, S. H., Darnell, J. S., & Allen, H. L. (2014). Affordable Care Act. Encyclopedia of Social Work.

Lexchin, J. (2017). Myths and realities about why prescription drug prices in the United States are so high. Pharmaceutical Medicine, 31(3), 143–148.

Meltzer, C. C. (2011). Summary of the Affordable Care Act. American Journal of Neuroradiology, 32(7), 1165–1166.

Sonfield, A., & Pollack, H. A. (2013). The Affordable Care Act and reproductive health: Potential gains and serious challenges. Journal of Health Politics, Policy and Law, 38(2), 373–391.


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Achievements, Challenges, and Future Improvements

Achievements, Challenges, and Future Improvements

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