Published on November 02, 2020

The Importance of the Affordable Care Act

By Doug Cropper

On November 10, the U.S. Supreme Court will hear arguments on one of the highest profile cases in our nation: a challenge to the Affordable Care Act. As I write this, many dynamics are in play -- the general election, the confirmation of Federal Court of Appeals Judge Amy Coney Barrett to succeed the late Supreme Court Justice Ruth Bader Ginsburg, and a COVID-19 pandemic that underscores the importance of health care coverage like never before.

While the fate of the landmark law is uncertain, I wanted to share why I support the ACA and how it has advanced health care over the past 10 years. I believe a repeal of the ACA would not only be detrimental to the patients we serve, but to the financial health of Genesis and health systems across the nation.

Here are some important facts about the ACA, also known as Obamacare:

• Expanded coverage: About 20 million Americans have gained health insurance coverage under the ACA.
• Coverage to those with pre-existing conditions: No one can be denied coverage because of a pre-existing health condition. Before the ACA, insurance companies could, and often did, deny coverage for a pre-existing condition, such as cancer.
• Medicaid expansion: The ACA has improved health outcomes for many Americans by enabling states to expand Medicaid, the source of health care serving low-income populations. In states that have expanded Medicaid, more people are receiving the right care, at the right time, in the right place. We know this reduces health care costs.
• Prevention and wellness: The ACA‘s emphasis on prevention requires insurance plans to cover many preventive, wellness, and chronic disease visits and screenings, with no out-of-pocket costs. This helps prevent or diagnose health problems before they develop into costly emergencies.
• Coverage for young adults: Because of the ACA, adult children can stay on their parents’ health plan until age 26.
• Accountable Care Organizations (ACO): The ACA authorized Medicare to change how it pays doctors and hospitals, incentivizing for quality outcomes and transitioning from a fee-for-service to a value-based system. ACOs, including our Genesis ACO, developed out of the need for a coordinated approach to keep people healthy and reduce health care costs.
• Uncompensated care: The ACA’s expansion of health insurance coverage has reduced uncompensated care at Genesis by millions of dollars each year. When the ACA became law in 2010, uncompensated care at Genesis was projected at $60 million for that year.

The ACA certainly is not perfect. If you will remember, President Obama signed the health care reform law on March 23, 2010. Things got off to a rocky start when the online enrollment for health insurance was difficult to navigate. Over the past decade, the law has been the subject of legal challenges, “repeal and replace” efforts, and repeatedly has been a top campaign issue.

Although polarizing, the ACA has extended health insurance coverage to millions of uninsured Americans and provided all Americans with health insurance consumer protections. It has been a lifeline for many of our patients. And, by reducing the skyrocketing demand for uncompensated care, it has helped ensure the economic vitality of Genesis and many health systems.

Without a strong replacement plan, a Supreme Court ruling overturning the ACA could be devastating for millions of Americans who buy affordable insurance through ACA marketplaces or who are on Medicaid due to the law’s expansion. As our nation grapples with a historic health crisis, now is not the time to take away the health insurance that is so important to millions.

If 2020 has taught us anything, it is that change and uncertainty will continue. So will our Genesis mission of compassionate, quality health services to all those in need. Safe, high quality, affordable, and accessible health care remains paramount for our patients and the communities we serve.


(Doug Cropper is president and CEO of Genesis Health System)