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Federal Programs

In 2009–10, the Obama administration and Democrats in Congress crafted and President Barack Obama signed into law the Patient Protection and Affordable Care Act (“Obamacare”). It dramatically increases the role of government in regulating medical service providers and health insurance markets.

The Issue

Defenders of Obamacare said it would bring about a new era of improved insurance coverage, lower premium prices, and a better health care experience for Americans of all walks of life. Instead, its launch at the end of 2013 was a train wreck, millions of people have lost their private insurance coverage, and premiums are rising. Medicaid expansion is expensive, creating new costs the federal government may not always cover and leaving state taxpayers on the hook for new liabilities.

ACA’s architects argued ensuring everyone had health insurance would encourage patients to take advantage of preventative care and use their own doctors instead of emergency rooms. The reality has been the opposite: The number of emergency room visits by low-income patients has increased since Obamacare went into effect.

Physician reimbursement also continues to pose a major problem, which has led to a physician shortage of approximately 63,000, with even more considering retirement.

Our Stance

ACA still has many problems demanding dramatic reforms or full repeal. Enrollment remains relatively low, costs are increasing, and few patients with coverage are using preventative care as expected. States that have not expanded Medicaid should stand fast because expansion does not improve health care outcomes and there is no guarantee federal funding will continue indefinitely.