I have written before that I’m not a fan of the Affordable Health Care Act.
Its provisions are, in many cases, not even remotely comparable to the ones that were in place under President George W. Bush’s Affordable Care Reform Act.
But the fact that they exist, and that they’re available to Americans at all, is enough to make me a fan.
The ACA, as I wrote in my blog post last week, is a much-needed expansion of coverage that makes health care affordable for millions of Americans.
And it also does a great job of making sure that every American, regardless of income, can afford to have health insurance coverage.
The ACA is a step forward, but not the last.
We need more steps.
The good news is that we are on the right track, thanks to the ACA’s provisions and the bipartisan efforts to repeal them.
It’s a step in the right direction, but the ACA remains a work in progress.
There are still major gaps in coverage, particularly among low-income Americans.
We can only hope that the Affordable Healthcare Act’s repeal and replacement will make it easier for people to obtain affordable, high-quality coverage.
But to reach that goal, we need to do more than repeal the ACA.
It will take the courage of a bipartisan majority to repeal and replace the ACA, and then move on to making sure we have coverage that is high-performing and affordable for everyone.
I’ve written before about the ACA as a model of how we can make health care universal, as a way to address the health disparities that exist between the rich and everyone else.
It offers Americans a simple and straightforward plan for expanding health care access for all Americans.
The key, I believe, is that the ACA has created a path to universal coverage.
While it does not address the issues that were the focus of President Bush’s reform plan, the ACA does provide the framework for how to address these issues.
The following four steps outline how to achieve that goal.
The first step is to ensure that everyone has coverage.
As I’ve written in my earlier posts, there is a clear path to achieving universal coverage through the ACA—and a lot of work remains to be done.
We will need to address both coverage gaps and barriers to access that exist.
As the Affordable Access Reconciliation Act (ACRA) was signed into law in July 2017, it expanded Medicaid to include more low- and moderate-income individuals.
As part of this expansion, people with incomes below 133 percent of the federal poverty level are eligible for Medicaid coverage, as are people with income between 133 and 138 percent of poverty.
We are working to expand Medicaid coverage to all Americans, including the millions of low-wage workers and the families of low income workers who are not eligible for coverage.
This expansion is being phased in over time, and as of 2018, nearly 5 million Americans were enrolled in Medicaid.
Medicaid expansion also expanded to include individuals with incomes above 133 percent and below 138 percent poverty.
The second step is for all of us to have access to quality, affordable health care.
The Affordable Care Acts Medicaid expansion included a number of measures that help lower-income people obtain affordable health insurance.
These include a cap on premium costs, limits on co-payments, and a special provision that provides health insurance to people with disabilities, those with mental health or substance abuse issues, and others.
The third step is ensuring that the health insurance available to people of all incomes is accessible and affordable.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is one of the most important pieces of legislation that Congress passed in the past decade.
It allows individuals to purchase health insurance across state lines, and the act requires insurers to offer coverage across state borders, making it easier to reach people who are less able to pay.
The fourth step is also essential to ensuring that we have the coverage that we need, and we need it now.
This will take concerted action on the federal and state levels.
As I wrote last week in my column, the Affordable Affordable Care act is a huge step forward in our country’s health care delivery system.
We have the infrastructure, the tools, and, most importantly, the will to make it happen.
But we need a president who is willing to take the next step, and one who will be bold enough to do so without sacrificing our national health and well-being.
We cannot afford to wait for the ACA to be repealed, replaced, or repealed again.
We must now act now, and to make sure that Americans have access and quality coverage, we must pass comprehensive legislation that improves access to care and improves the health outcomes for all.