Comment by dmschulman | Hacker News Reader

Comment by dmschulman | Hacker News Reader

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There's a multitude of evidence that points to the success of the ACA from a cost perspective (among other things).

Cost of healthcare for individuals is not a good metric to judge by. The ecosystem of hospitals, patients, doctors, insurers, health systems, and the federal government is complex and you're not going to get a clear picture of the overall impact of the ACA by looking as something as simple as cost savings.

One example, hospitals are required to treat patients whether or not they hold insurance. The hospital foots the bill for that care and it's a major reason why hospitals shut down (especially in underserved communities). Getting more people on insurance plans was a direct factor is keeping many struggling hospitals and health systems afloat.

https://www.statnews.com/2019/03/22/affordable-care-act-cont...

https://www.networkforphl.org/news-insights/the-affordable-c...

https://www.cbpp.org/research/health/chart-book-accomplishme...

If the ACA was so successful at reducing coats we wouldn't still be having discussions like this about the excessive costs of both care and insurance in the US.

We will never know how costs would have changed if we didn't implement the ACA, and cost is not the only metric of success. But it clearly hasn't led us to a place where people feel okay with what the industry costs.

The purpose of the ACA was to get more people to sign up for health insurance by creating plans everyone could access regardless of employment status or income. Solving the healthcare crisis in this country from top to bottom is going to take more than an act of Congress.

Also necessary to remember the ACA was only passed because of Democratic support in 2010. Republicans hacked away at the proposal before it became law, kneecapping any real institutional changes it had contained, and have effectively killed it since becoming the majority in the House and Senate in 2024. That bipartisan support piece is required in order for anything meaningful to happen.

Making healthcare more affordable was literally in the name. I agree they also aimed to expand coverage, but cost reduction as a top line item and my point was simply that it didn't land that goal.

At a minimum since we don't know what prices would be today without the ACA, prices have risen dramatically in recent years to a point that I think most agree its unaffordable.

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