eibner et al ., 2017 ). aca requires H e a l t h M e d i c a l

eibner et al ., 2017 ). aca requires H e a l t h M e d i c a l

1.The Affordable Care Act, also know as Obamacare was meant to lessen health care disparities due to lack of insurance. Access to health care is essential to maintain health and wellness. The Affordable Care Act had 3 major goals, increase healthcare coverage, reduce rising cost and improve the quality of care. The American Health Care Act was meant to “repeal and replace” the Affordable Care Act. One of the major criticisms of the ACA is the fines imposed for those that did not choose to be insured. The AHCA did not have such penalties, however, it also did not have protection for those with a preexisting condition. It also would have left many uninsured and in a more vulnerable position. I believe these are some of the reasons that the AHCA failed its first attempt.

Mason D., Gardner D., Outlaw F., & O’Grady E., (2020). Policy & Politics in Nursing and Healthcare. 8th Ed. Elsevier. 9780323554985

2. Current provisions in the ACA with those in the failed first version of AHCA

Healthcare reforms have been given several attempts by federal governments. In 2010 President Barack Obama introduced the Patient Protection and Affordable Care Act (ACA) through congress but did not get any Republican vote. In 2017 Republicans, through their House of Representatives, introduced their replacement for the ACA with American Health Care Act (AHCA) (Eibner et al.,2017).

ACA requires a federal tax penalty for failing to enroll in an insurance plan, while AHCA does not make it mandatory. ACA has plans to offer additional benefits such as preventative care, while AHCA does not unless a state receives a waiver from the federal government (Eibner et al.,2017). In the ACA, the government is in charge of managing Medicaid, while under the AHCA, the states are designed to manage Medicaid. The AHCA has made proposals to introduce Federal Invisible Risk Sharing Program that the government sets aside to aid insurance companies in covering high medical costs for patients. At the same time, ACA does not provide this risk program.

Opinions why AHCA failed in the first attempt at passage

Medicaid expansion is a big concern with AHCA, with some states limiting acceptance to new expansion enrollees starting 2020 (Hirsch et al., 2017). AHCA has introduced a cap that allows healthcare coverage companies to impose a penalty on individuals who allow their insurance coverage to lapse. ACA made provisions of different insurance subsidies based on costs and income, but AHCA intended to replace the subsidies with age-based credits (Hirsch et al., 2017). Besides, AHCA would have encouraged healthcare saving accounts (HSAs), which is consistent with the long-standing Republican position. In summary, both ACA and AHCA are healthcare reforms introduced in America under different governments, each seeking to offer Americans the best medical care.


Eibner, C., Liu, J. L., & Nowak, S. (2017). The effects of the American Health Care Act on health insurance coverage and federal spending in 2020 and 2026. Arlington (VA): RAND Corporation.

Hirsch, J. A., Rosenkrantz, A. B., Nicola, G. N., Harvey, H. B., Duszak, R., Silva, E., … & Manchikanti, L. (2017). Contextualizing the first-round failure of the AHCA: down but not out. Journal of NeuroInterventional Surgery, 9(6), 595-600.