Obamacare: Health Finance & Delivery Policy

Subject: Healthcare Financing
Pages: 3
Words: 586
Reading time:
3 min
Study level: Bachelor

One of the most crucial indicators of any country’s state of the art is its healthcare policy and related legislation regulating the mentioned sphere. Citizens’ health might be a vital aspect of national harmony within a state. Hence, when people need treatment, they should be provided with high-quality medical services, insurance, and compensations. In the US, the Affordable Care Act is meant to be a mechanism for reducing the burden of uncompensated care. Thus, the discussion about whether the Act is effective and does it have alternatives might be a relevant action to undertake.

A dimension of scholarly studies has a plethora of investigations about the issue. The purpose of the Affordable Care Act (the ACA) is to reduce the number of US citizens who have no medical insurance. To that end, the ACA offers tax credits to provide an opportunity for private insurance purchases as well as expands the right for Medicaid (Shi, 2014). Moreover, the Act “requires all not-for-profit hospitals to have charity care policies” as, at times, it may be the only way to get free treatment for poor people (Valdovinos et al., 2015, p. 1296). When the Affordable Care Act’s first open enrollment launched in October 2013, the uninsured rate was 17.1% (TNHFMA, 2015). By January 2015, that number decreased to 12.9%, which means that about 13 million Americans had new medical insurance (TNHFMA, 2015). So, keeping in mind the mentioned facts, the ACA might seem an effective tool to deal with uncompensated care.

However, the Act has some considerable limitations that result in doubts about its absolute effectiveness. For instance, vulnerable populations usually lack the possibility of compensated care as pressure on safety net providers (because of the increasing number of low-income citizens seeking care) takes place (Shi, 2014). Then, the ACA gives no specific details about implementing charity care by hospitals. It results in the fact that “not-for-profit hospitals sometimes behave more like economic entities … instead of charity operations” (Valdovinos et al., 2015). Nevertheless, Goodnough (2016) gives a significant example when the man “had no insurance through his job at a 7-Eleven, but it turned out he was eligible for Medicaid under the Affordable Care Act” (para 2). What is more, before the Act, hospitals had to cover the expenses for the treatment of many uninsured people.

Donald Trump and the Republicans vowed to dismantle the Affordable Care Act. They claim that their plan aims to provide states with flexibility to realize effective health care policies. Scholars give many alternatives to the ACA, such as implementing “a single-payer health care system” (Liu & Brook, 2017, p. 830). However, American hospitals have been against the repeal of the Act. In their letter, they stated that it may lead to a “public health crisis” and that about 20 million people will “lose the insurance they gained under the law” (Goodnough, 2016, para 4). Thus, it seems reasonable not to replace the law that still might be considered effective, but to improve it by filling the gaps within its provisions.

In conclusion, it might be assumed that the Affordable Care Act remains a mechanism reducing the burden of uncompensated care relatively efficiently. However, it has several limitations that resulted in Trump’s decision to repeal the law. Keeping in mind the advantages of the ACA and that healthcare providers are against such action, it may be more rational to remove the limitations of the ACA by addressing the gaps in it. For instance, legislators may detail the implementation of charity care by hospitals.


Goodnough, A. (2016). Safety-net hospitals fear cuts as health law’s repeal looms. New York Times. Web.

Liu, J. L. & Brook, R. H. (2017). What is single-payer health care? A review of definitions and proposals in the U.S. Journal of General Internal Medicine, 32(7), 822-831.

Shi, L. (2014). Health policy related to financing and delivery. In Introduction to health policy (pp. 99-117). Chicago, Illinois: Health Administration Press.

TNHFMA. (2015). Solving the problem of uncompensated care [Video file]. Web.

Valdovinos, E., Le, S., & Hsia, R. Y. (2015). In California, not-for-profit hospitals spent more operating expenses on charity care than for-profit hospitals spent. Health Affairs, 34(8), 1296–1303.