Perspective: Building on the ACA to Advance Health for All

“Don’t let perfect be the enemy of the good” is a quote credited to the French writer and thinker Voltaire. Although he died in 1778, that phrase is very appropriate today when discussing the Affordable Care Act.

Enacted 10 years ago, the ACA has made substantial progress toward its goal of improving Americans’ access to quality health care. Millions of individuals have health insurance coverage because of the law’s many reforms, including Medicaid expansion and protections for people with pre-existing conditions. And there is significant evidence that the ACA is responsible for strengthening public health, including improved health status for racial and ethnic minorities.

We know the law is not perfect … few laws are. After all, how many times have Medicare and Medicaid been amended over the past 55 years? The bottom line: The ACA has provided a solid and practical foundation for our continued journey toward universal coverage, as well as improving health care. And we believe there are certainly opportunities to build on it to make it better.

Earlier this week, the Supreme Court heard oral arguments in the latest challenge to the constitutionality of the ACA. Like we have done in the two previous challenges that came before the high court, the AHA continues to defend the law because we believe expanding health coverage to those who have been shut out in the past cannot be separated from our core mission of advancing health for all in America.

And while the sentiment after the oral argument was that key justices signaled support for keeping the law in place, we know that striking it down would cause millions of Americans to lose their health coverage and that low-income families would be hardest hit by the harm that comes with being uninsured.

Regardless of how the court rules in this case, we are committed to building on the ACA to lower the uninsured rate, as well as expand access, improve care and lower costs.

On the coverage side specifically, there are a number of efforts we are engaged in now.

COVID-19 has amplified the importance of having health insurance coverage. But the economic downturn caused by the pandemic also has forced many individuals to find other ways to obtain coverage. As part of our advocacy efforts to secure additional COVID-19 relief, we continue to urge Congress to prioritize maintaining health benefits for individuals and families and increase coverage options for those who are already uninsured.

In addition, open enrollment for 2021 health care coverage in the individual marketplace continues until Dec. 15. Hospitals and health systems can help spread the word about open enrollment and other coverage opportunities, such as Medicaid and the Children's Health Insurance Program, to help their communities get covered. Visit AHA’s webpage and www.HealthCare.gov for resources to assist you in those efforts.

And in the event that the Supreme Court next year throws out the entire law, we will regroup and pursue everything that’s necessary to make sure that those coverage provisions remain intact. That’s because health care coverage is an essential component of achieving the AHA's vision of healthy communities, where all individuals reach their highest potential for health.