TY - JOUR
T1 - The future of the affordable care act and insurance coverage
AU - Glied, Sherry
AU - Jackson, Adlan
PY - 2017/4
Y1 - 2017/4
N2 - We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisionsofthe ACA, including the Medicaid expansion and the structure of premium subsidies, havebeen associatedwith large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage. We find that many replacement proposal components, including flat tax credits and maintaining cost savings provisions, could jeopardize the ability of many of the ACA's primary beneficiaries, as well as other Americans, to access coverage and care. By leading to a deterioration of the safety net, these strategies could also imperil population health activities.
AB - We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisionsofthe ACA, including the Medicaid expansion and the structure of premium subsidies, havebeen associatedwith large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage. We find that many replacement proposal components, including flat tax credits and maintaining cost savings provisions, could jeopardize the ability of many of the ACA's primary beneficiaries, as well as other Americans, to access coverage and care. By leading to a deterioration of the safety net, these strategies could also imperil population health activities.
UR - http://www.scopus.com/inward/record.url?scp=85018496344&partnerID=8YFLogxK
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U2 - 10.2105/AJPH.2017.303665
DO - 10.2105/AJPH.2017.303665
M3 - Article
C2 - 28207344
AN - SCOPUS:85018496344
VL - 107
SP - 538
EP - 540
JO - American Journal of Public Health
JF - American Journal of Public Health
SN - 0090-0036
IS - 4
ER -