Resolving the Affordable Care Act: Key Fixes for a Better Healthcare System

The Affordable Care Act (ACA), also known as Obamacare, has been a topic of heated debate since its inception. While the law has provided health insurance coverage to millions of Americans, it has also faced criticism for its complexities and potential shortcomings. In this blog post, we will delve into some key fixes that could improve the ACA and make it more effective in providing affordable and accessible healthcare to all Americans.

Addressing Employer-Sponsored Health Insurance:

One of the major concerns with the ACA is its treatment of employer-sponsored health insurance. Currently, individuals who have access to affordable employer-sponsored insurance are not eligible for federal subsidies to purchase health insurance through the exchanges. This creates a situation where individuals may be financially penalized for having employer-sponsored coverage.

To address this issue, a reasonable solution would be to allow employees with affordable employer-sponsored insurance to still qualify for federal subsidies if they choose to purchase a plan through the exchange. This would provide individuals with more flexibility and allow them to choose the plan that best meets their needs and financial situation.

Eliminating the Employer Mandate:

Another controversial aspect of the ACA is the employer mandate, which requires businesses with 50 or more full-time employees to provide health insurance coverage to their workers. This mandate has raised concerns about increased costs for businesses and the potential for employers to reduce hours or lay off workers to avoid the requirement.

Eliminating the employer mandate could alleviate these concerns and give businesses more flexibility in managing their employee benefits programs. However, it is important to consider the potential impact on the health insurance market if a significant number of employers drop coverage.

Reforming Medicaid Estate Recovery:

Medicaid estate recovery refers to the practice of states seeking reimbursement from the estates of deceased individuals who received Medicaid benefits. This policy has been criticized as being unfair, particularly in cases where individuals have already spent their assets on medical expenses during their lifetime.

Reforming Medicaid estate recovery could involve eliminating the practice altogether or limiting it to cases where individuals have significant assets that were not spent on medical expenses. This would provide more financial protection for families and prevent them from being burdened with large medical debts after a loved one’s passing.

Expanding Subsidies for Low-Income Individuals:

Another area for improvement in the ACA is the coverage gap for low-income individuals in states that have not expanded Medicaid. In these states, individuals who earn less than 100% of the federal poverty level do not qualify for either Medicaid or premium subsidies through the exchanges.

Expanding subsidies for low-income individuals would close this coverage gap and ensure that all Americans have access to affordable health insurance. This could be achieved by lowering the eligibility threshold for premium subsidies or by providing a separate subsidy program for individuals in non-expansion states.

Restoring Funding for Non-Profit Co-op Insurance Loans:

The ACA established a program to provide start-up loan funding for non-profit co-op health insurance plans. These co-ops aim to increase competition in the health insurance market and offer more affordable options to consumers. However, funding for this program has been reduced in recent years.

Restoring funding for non-profit co-op insurance loans would support the development of these organizations and foster competition in the health insurance market. Co-ops have the potential to provide more affordable and responsive health insurance plans, particularly in rural and underserved areas.


The Affordable Care Act has been a transformative piece of legislation that has expanded health insurance coverage to millions of Americans. However, there is room for improvement to make the law more effective and to address the concerns raised by critics. By implementing these key fixes, we can strengthen the ACA and ensure that all Americans have access to affordable, high-quality healthcare. It is important to note that any changes to the ACA would require congressional action, and it is uncertain whether these particular fixes would be supported by lawmakers. Nonetheless, we hope that this discussion can contribute to a broader dialogue about improving our healthcare system.

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