Putting Insurance Reform in the ACA’s Rear-View Mirror

Source: William M. Sage, University of Texas at Austin School of Law, Public Law Research Paper No. 551. January 10, 2014

From the abstract:
In the continuing controversy over the expansions of health insurance coverage contained in the Patient Protection and Affordable Care Act of 2010 (ACA), it often escapes notice that the law also attempts to improve the efficiency of health care services and the underlying health of the population. This essay describes the ACA’s goal of concurrent reform of health insurance, health care services and health as the law’s “true breakthrough and its arguable overreach.” The essay explains why the ACA’s decision to double down on coverage even in the face of rising costs and declining health may have been a reasonable one. However, it cautions that the problems that have arisen with respect to insurance coverage — the easiest part of health reform — do not bode well for more difficult public conversations over health care and health that must follow.