As the election draws nearer and the candidates gear up for debate, one of the hot topics being discussed is the Affordable Care Act (ACA), better known as Obamacare. While some find the mention of it to be cringe-worthy, others laud the Obama administration for its success, claiming that every American can now have access to health coverage. Now, six years after it was signed into law, this common assertion is completely false. Not only are millions of Americans still without coverage, but the United States has by far the highest healthcare costs of any developed nation. So the question remains: did Obamacare actually achieve what it was meant to? 

Upon implementation, Obamacare cut funding to hospices and end-of-life care facilities by hundreds of millions of dollars. Furthermore, higher taxes were levied on businesses and top earners in order to fund the increase in coverage to individuals that did not have care before the ACA. Small businesses were also mandated to provide coverage if they had 50 or more employees. As a direct result, businesses had to cut the hours of full time employees or completely eliminate positions in order to get around this requirement and keep costs low.  

Insurance premiums have risen and will continue to rise under the ACA, as competition between insurance companies is hindered. At its core, insurance is a form of risk transfer in which the insurer wages a bet on the fact that individuals will not become sick as they collect a monthly premium from the insured. Because of the mandate that no one can be denied coverage due to a pre-existing condition, insurance companies must cover sick people, thus raising the cost of insurance for everyone as the ratio of sick people to healthy people increases. The mandate of Obamacare increases the odds that covered individuals will become sick, and insurance companies will have to cover the cost. It has created a system between individuals and insurers in which the insurers are bound to lose. 

In August 2016, Aetna, one of the largest private insurers in America, stated that it would reduce its participation in public exchanges for health insurance policies under Obamacare within the coming year due to increased financial losses. Aetna incurred a pre-tax loss of over $400 million since 2014, and it is not the only insurer to experience severe loss. Since 2010, proponents of Obamacare have argued that the increase in preventative care provided would outweigh the financial burden of extending coverage to people with pre-existing conditions. Over the past six years, however, this has not been the case.  

Moreover, while Obamacare purports to be helping millions of Americans, there are millions  who are still hurting. The biggest losers with this new system are healthcare providers, particularly private practice physicians. With reduced insurance reimbursements to hospitals and private practice offices, what will be the incentive to go into the medical field? Why would a student take on tens of thousands of dollars of debt to emerge from medical school with a mediocre salary and to spend countless nights working long shifts? 

The point which the Obama administration has repeatedly failed to convey is that healthcare, just as a new car or a new home, needs to be budgeted for. The ideology Obamacare peddles is that individuals without existing coverage can log online, enter a simple questionnaire and receive immediate coverage. Again, the Obama administration tramples the middle class Americans who save and budget for their healthcare costs. This suppression of the middle-class has undoubtedly become the established norm over the last eight years of his presidency.

The bottom line is that Obamacare more closely aligns us with European healthcare markets and socialized care in which a single-payer system purports care rationing and long wait lists for non-urgent surgeries. Looking forward, the United States as a whole needs to ensure long-term stability in the healthcare sector, not instill fear in the general public due to rapidly rising costs. 

So, while Obamacare has extended coverage to some that need it, it has not come without a large price tag, mainly at the expense of small businesses and healthcare providers. Should Obamacare be repealed? At this point, it’s apparent that we are in too deep to completely do away with it. Undoubtedly, it is not a total failure. Can it be improved? Absolutely.