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The Affordable Care Act (ACA) involves numerous provisions and regulations to health care. There are positive and negative aspects to each federal policy, but can legislation produce sustainable high-quality health care? Government intervention through the Affordable Care Act (ACA) has transformed the financing and delivery of health care (Wiley & Matthews, 2017). While policies are generally produced to benefit as many people as possible, they can also create challenges (Conti & Jones, 2017; Hall & McCue, 2016). The ACA affects quality of health care in both public and private sectors (Conti & Jones, 2017). It can be argued that legislation, such as the Affordable Care Act, will not produce sustainable high-quality health care.

The goal of the ACA is to provide affordable medical coverage to American citizens, which includes Medicaid expansion and health insurance exchange maintenance (Conti & Jones, 2017). However, the ACA could place an unnecessary strain on health care. Legislation, including the ACA, creates challenges across states as it is the responsibility of each state to make decisions based on the policies and incentives (Conti & Jones, 2017; Wiley & Matthews, 2017). While the ACA has the potential to create affordable and high-quality health care, it falls short of creating a united front between diverse health care stakeholders behind a shared vision of value (Larkin, Swanson, Fuller, & Cortese, 2016). Gaps in health care have been created by the ACA and will require cooperation across several sectors, including public health and medical, behavioral, and social services, in order to have a chance of producing sustainable high-quality health care (Conti & Jones, 2017; Hall & McCue, 2016).

On a positive note, the ACA created a marketplace that prohibits insurers from considering subscribers’ health status and created a structure that facilitates comparison shopping (Hall & McCue, 2016). However, as a result of the ACA, premium rates have increased, new established private insurers focused on the individual market have failed, and private-sector preparedness to adopt future policies varies between states (Conti & Jones, 2017; Hall & McCue, 2016). This creates a vision of decreased value and quality care as patient outcomes are affected by cost (Larkin et al., 2016). It is evident that government intervention through legislation is intended to benefit the involved parties. While the ACA has potential to produce sustainable high-quality health care, various challenges, including a lack of a shared vision across all levels, will prohibit sustainable high-quality health care from becoming a reality (Conti & Jones, 2017; Larken et al., 2016).


Conti, R. M., & Jones, D. K. (2017). Policy diffusion across disparate disciplines: Private- and public-sector dynamics affecting state-level adoption of the ACA. Journal of Health Politics, Policy & Law, 42(2), 377-385. doi: http://dx.doi.org.lopes.idm.oclc.org/10.1215/03616878-3766771

Hall, M. A., & McCue, M. J. (2016, July 20). How has the affordable care act affected health insurers’ financial performance? [web log comment]. Retrieved from https://www.commonwealthfund.org/publications/issue-briefs/2016/jul/how-has-affordable-care-act-affected-health-insurers-financial

Larkin, D. J., Swanson, C.R., Fuller, S., & Cortese, D. A. (2016). The Affordable Care Act: A case study for understanding and applying complexity concepts to health care reform. Journal of Evaluation in Clinical Practice, 22(1), 133-140. doi: https://doi-org.lopes.idm.oclc.org/10.1111/jep.12271

Wiley, L. F., & Matthews, G. W. (2017). Health care system transformation and integration: A call to action for public health. Journal of Law, Medicine & Ethics, 45, 94–97. doi: https://doi-org.lopes.idm.oclc.org/10.1177/1073110517703335


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