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The Affordable Care Act: A Primer

In 2002’s State of the Union address, George Bush asserted that the United States had “the finest health care system in the world.” Today, no politician would dare make that claim for fear of being laughed out of office. Even in 2000, a system developed by the World Health Organization that ranked nations based on quality and access to healthcare placed the United States in 37th place, sandwiched between Costa Rica and Slovenia.

Americans have long struggled with the pitfalls of the United States’ healthcare system, and in 2010, American leaders finally took heed: On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law. The ACA dramatically changed the landscape of American healthcare in its purpose to expand healthcare coverage, regulate costs of care, and improve the healthcare delivery system.

While the ACA is a strong step in the direction of universal healthcare coverage, regardless of ability to pay, there still remains a wide gulf between the United States and other OECD nations in regards to healthcare costs and coverage. Among OECD countries, the United States’ healthcare system consistently ranks first for costliness, and last for coverage. How is it that France, ranked #1 in the world for its healthcare system, spends approximately $3300 per capita on healthcare, while the United States spends more than double that (about $7200 per capita), yet comes in at #37?

Evidently, there is no fast and easy way to bring the American healthcare system up to par with those of comparable nations. It is clearly possible to cut costs dramatically while still increasing healthcare coverage and quality, and the ACA speaks to that two-fold purpose.

Below is a brief, illustrated digest of the 900-page ACA, incorporating key changes brought about Supreme Court cases over the past five years.


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