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April 5, 2016

How Well Is the Affordable Care Act Doing?Reasons for Optimism

Author Affiliations
  • 1Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia
  • 2Department of Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia
JAMA. 2016;315(13):1331-1332. doi:10.1001/jama.2016.2556

The Affordable Care Act (ACA) is now 6 years old. Fair-minded people want to know whether the ACA is succeeding. Even more important is the question of how it will do in the future.

The context of the ACA’s past is important for understanding its future. The ACA narrowly passed. A more liberal bill, such as Medicare for all, stood no chance of enactment, even if it constituted a better option. In addition, the ACA is not a perfect bill. As with any piece of legislation in a democracy, the ACA was the result of compromises and trade-offs. It constituted progress, not perfection.