The Affordable Care Act: A Great Unraveling? A Talk by Sara Rosenbaum


September 28, 2017

At a time when the Congress was attempting to repeal and replace the Affordable Care Act (ACA), nationally recognized expert on heath policy Sara Rosenbaum spoke to students at George Washington University’s Milken Institute School of Public Health (Milken Institute SPH) about the potential impacts of the act’s unraveling in the talk recorded in this video.

Rosenbaum is the Harold and Jane Hirsh Professor of Health Law and Policy at the Milken Institute SPH’s Department of Health Policy and Management, and her update on the current healthcare legislative environment began with information about the ACA’s achievements. 

Most importantly, she pointed out, the percentage of uninsured Americans dropped from 18.2 percent in 2010 to at most 10.3 percent in 2017.  “There are people who are experts in the effects of laws who have done studies to suggest that the most significant factor in this drop—because we also went through an economic recovery, and there are constant changes in economic circumstances, labor circumstances, demographic circumstances; things that might change insurance distribution across the population—is the effects of the law,” Rosenbaum said. 

Watch the video to learn Rosenbaum’s take on why the ACA law is convoluted and complicated and much more, including:

  • Why Rosenbaum likens the private insurance market to a hot house flower
  • Why the ACA’s incentive for young and healthy people to purchase insurance is important
  • How the ACA’s cost-sharing provisions shield lower income people from the high cost of coverage
  • Insights into why the states that expanded Medicaid had the greatest gains in the percentage of insured residents
  • Why states with small populations and small risk pools struggle under the ACA
  • Rosenbaum’s summary of challenges to the law
  • Rosenbaum’s thoughts on how the Congress can improve the law by stabilizing the market and tackling cost-sharing subsidies