Patient Protection and Affordable Care Act: Improvement or Liability

Subject: Administration and Regulation
Pages: 5
Words: 1108
Reading time:
5 min
Study level: Master

Patient Protection and Affordable Care Act (PPACA), more commonly known as Obamacare, is major legislation passed in 2010 by President Barack Obama and the Democratic Party. Since the day of its passage, it has been a matter of controversy for various reasons. On the one hand, it is a considerable step toward universal access to health care. It helped to purchase health insurance for millions of Americans while eliminating discrimination against people with pre-existing conditions. On the other hand, the implementation is supposed to be financed by a variety of unpopular measures.

For instance, it forces all US citizens who can afford health insurance to purchase it or pay a fee to the government. However, even though the legislation is thought of as a liability by the Republican Party, it is a significant improvement to the healthcare system in the US.

PPACA as an Improvement

The primary purpose of the PPACA is to make healthcare in the US more affordable for everyone. Traditionally, healthcare in the US was based on fee for service principle with ultimately no control over pricing from the government. The practice made it virtually impossible for an average citizen to pay for the health care services out of pocket. According to Durenberger (2015), the US before the PPACA may be characterized with “dysfunctional doctor-patient relationships and the unrealistic financial rewards for specialization, diagnostic tests, drugs, and medical devices” ( p. 665).

Indeed, instead of being focused on valued-based outcomes and population health, the American healthcare system aimed at providing acute care. Four decades of trials and errors have led to the emergence of Obamacare as a chance to change the situation.

PPACA has increased access to health insurance through various mechanisms. According to Hoffman and Goodnough (2019), around 21 million Americans can afford health insurance only due to the legislation. Indeed, the law allowed people in the “Medicare gap” to receive support in purchasing insurance plans. For instance, Bagley (2015) describes a case how his child’s piano teacher was not able to afford health insurance before Obamacare since she had only a part-time job and was not able to apply for Medicaid. Additionally, it forced all the organizations that have more than 50 employees to offer health insurance support (Lee, 2017). As a result, healthcare services became available for an increased number of people.

Before the passage of the legislation, insurance companies were able to deny coverage without explanation and discriminate against people with pre-existing conditions. PPACA made all the providers sell health insurance to all, without the ability to charge sick people more (Lee, 2017).

Additionally, the insurance companies must have an appeal process for claims that were turned down, so clients may have recourse other than a lawsuit (Political Irony, 2014). The plan is to discard the term “pre-existing condition” and provide equal pricing for everyone disregarding their health status. The endeavor is crucial for maintaining the principals of democracy and the US Constitution.

Obamacare also enabled millions of Americans to receive relevant, up-to-date information about the prices of insurance plans. PPACA encourages all the states to create health care exchanges, easy-to-use websites that allow comparison of different insurance plans. Even though 34 states refused to establish such exchanges, with the help of the federal government, all the US citizens with an internet connection can access this information (Bagley, 2015).

Moreover, a government website was created to give people insurance and health information (Political Irony, 2014). Increased access to knowledge about rights and privileges enabled Americans to receive healthcare services. In summary, Obamacare allowed millions of US citizens to practice their constitutional rights and prevent discrimination. However, some politicians believe that PPACA violates fundamental American laws.

Obamacare as a Liability

Obamacare is an expensive law to enforce, and it is unwelcome by many stakeholders. Trump’s administration considers the law unconstitutional and forms a request to strike down PPACA (Hoffman & Goodnough, 2019). Even though it is unclear whether the request will survive the judicial scrutiny, the fact makes it clear that the legislation is a controversial matter with many pitfalls that primarily focus on the question of who is to pay for the implementation of the law.

PPACA is supposed to be financed from additional taxation on the uninsured and the upper class. According to Political Irony (2014), US citizens with yearly income above $200,000 experience a tax increase of 0.9% to help pay for the reform. Additionally, now if a person can afford health insurance, he or she is obliged to have it or to pay a fee to the government (Political Irony, 2014). Even though the matter is reasonable as a tradeoff for pre-existing conditions, it is met with discouragement by the people. As a result, in 2017, the tax penalty for the uninsured was eliminated by Congress, causing even more dissatisfaction among health insurance companies (Hoffman & Goodnough, 2019). In short, the change aroused discontent among many stakeholders of the healthcare system.

In addition to the issues discussed above, employers may tend to cut employee hours to reduce the costs of health insurance. As stated above, organizations with 50 or more employees are now obliged to offer health insurance plans to their workers. Since employers are not always eager to provide such plans, they may tend to have fewer full-time employees to avoid meeting the cap of 50. As a result, ordinary citizens have less income and benefits.


Even though some stakeholders actively obstruct the implementation of the healthcare reform proposed by President Obama, it seems that it has more benefits than flaws. While the question of who is to pay for the changes remains negotiable, the need for change is evident.

The law is not ideal; however, there is no formulated alternative to the legislation. Even though President Trump claims that he will always support pre-existing conditions, and he will create a better and less expensive plan, there are no adequate substitutes for it yet. Durenberger (2015) supports the opinion by stating that “systemic health reform is here to stay” (p. 666). In short, PPACA is legislation beneficial for the majority of the stakeholders; however, it will be altered and improved to meet the needs of modern society.


Obamacare is a controversial policy as it touches the interests of all the stakeholders in the healthcare system, which may have different and sometimes competing views. Even though the legislation has some evident cons, they are outnumbered by the pros, among which are increased access to healthcare services and decreased discrimination against people with pre-existing conditions. In conclusion, a thorough analysis of PPACA shows that it is an improvement to the US healthcare system rather than a liability.


Bagley, N. (2015). Three words and the future of the Affordable Care Act. Journal of Health Politics, Policy and Law, 40(3), 589-597. Web.

Durenberger, D. (2015). Health care reform and the American Congress. The Milbank Quarterly 93(4), 663-666.

Hoffman, J., & Goodnough, A. (2019). Trump administration files formal request to strike down all of Obamacare. New York Times. Web.

Lee, M. (2017). Obamacare vs. AHCA and BCRA. Modern Healthcare 47(26-27), 01607480.

Political Irony. (2014). Obamacare explained so everyone can understand it. Web.