Last updated on: 5/8/2015 12:34:59 PM PST
Is the Patient Protection and Affordable Care Act (Obamacare) Good for America?

PRO (yes)

Paul Krugman, PhD, Nobel Prize-winning economist, stated in his Oct. 8, 2014 article for Rolling Stone titled "In Defense of Obama":

"Obamacare means a huge improvement in the quality of life for tens of millions of Americans – not just better care, but greater financial security. And even those who were already insured have gained both security and freedom, because they now have a guarantee of coverage if they lose or change jobs.

What about the costs? Here, too, the news is better than anyone expected. In 2014, premiums on the insurance policies offered through the Obamacare exchanges were well below those originally projected by the Congressional Budget Office, and the available data indicates a mix of modest increases and actual reductions for 2015 – which is very good in a sector where premiums normally increase five percent or more each year. More broadly, overall health spending has slowed substantially, with the cost-control features of the ACA probably deserving some of the credit.

In other words, health reform is looking like a major policy success story. It's a program that is coming in ahead of schedule – and below budget – costing less, and doing more to reduce overall health costs than even its supporters predicted…

And this big improvement in American society is almost surely here to stay… Health reform has made America a different, better place."

The American College of Physicians (ACP), a national organization of internists, stated in its Feb. 11, 2014 letter to Kathleen Sebelius, then-US Secretary of Health and Human Services, written by then-ACP President Molly Cooke, MD, and available at the ACP website:

"With millions of Americans now enrolled or preparing to enroll in marketplace-based qualified health plans and Medicaid, it is apparent that the Affordable Care Act is approaching its goal to reduce the number of uninsured, improve the quality of the health care delivery system, and drive down costs.

ACP remains committed to supporting the Affordable Care Act and enabling the nation's internists to provide their patients with the tools to enroll in affordable health insurance and steer the nation's health care system to deliver high-quality, high-value care...

The College believes that the Affordable Care Act represents an historic step forward to providing all Americans with access to affordable coverage without regard to their health status, their gender, where they work or live, or how much they earn."

Sylvia M. Burwell, US Secretary of Health and Human Services (HHS), stated in her Feb. 19, 2015 op-ed for USA Today titled "HHS Secretary: Affordable Care Act Is Working":

"Over the past three months, millions of Americans sent a powerful message: The Affordable Care Act is working, and the quality health coverage offered on its Health Insurance Marketplace is a product that consumers need, want and like… We've achieved an historic reduction in the uninsured – the largest over any period since the early 1970s…

The Affordable Care Act is now an important part of the everyday lives of millions of Americans. They finally have the financial and health security that comes with affordable health coverage. They now can fill prescriptions and take their children to the doctor. Some no longer have to choose between paying for health care and paying their utility bill…

Expanding access to quality, affordable health coverage is about making progress for the hardworking families that rely upon the financial security and peace-of-mind that comes with it."

Barack H. Obama, JD, 44th President of the United States, stated during his Mar. 25, 2015 "Remarks by the President Marking the Fifth Anniversary of the Affordable Care Act," available at the White House website:

"[J]ust five years in, the Affordable Care Act has already helped improve the quality of health care across the board... It's helped reduce hospital readmission rates dramatically. It's a major reason why we've seen 50,000 fewer preventable patient deaths in hospitals...

If you get insurance through your employer, like most Americans do, the ACA gave you new savings and new protections. If you've got a pre-existing condition like diabetes or cancer, if you've had heartburn or a heart attack, this law means that you can no longer be charged more or denied coverage because of a preexisting condition, ever. It's the end of the discrimination against the sick in America, and all of us are sick sometimes.

If you don't have health insurance, you can go online to the marketplace and choose from an array of quality, affordable private plans. Every governor was given the option to expand Medicaid for his or her citizens, although only 28 have chosen to do so -- so far. But after five years of the ACA, more than 16 million uninsured Americans have gained health care coverage -- 16 million. In just over one year, the ranks of the uninsured have dropped by nearly one-third -- one-third...

But the bottom line is this for the American people: The Affordable Care Act, this law, is saving money for families and for businesses. This law is also saving lives -- lives that touch all of us. It's working despite countless attempts to repeal, undermine, defund, and defame this law."

Michael Hiltzik, MSc, Pulitzer Prize-winning journalist with the Los Angeles Times, stated in his Oct. 2, 2014 article titled "Obamacare at One Year: A Birthday Assessment," available at

"How's it [Obamacare] doing? The inescapable answer is: very well, thank you. This will disappoint the legions of politicians and pundits, chiefly Republicans and conservatives, who became heavily invested in the act's failure--so heavily that where they couldn't point to tangible evidence of failure, which was most of the time, they resorted to distortion, outright fabrication and obstructionist legal strategies…

The signs are that America's old system of health coverage, which relied on employer-sponsored care and condemned those without it to enormous premiums, to uninsurability, and to unmet medical needs, is being supplanted by a new system in which coverage is available to everyone at a reasonable and affordable price, no one needs to feel trapped in a job merely for the insurance, and the prospect of medical bankruptcy will recede over time.

There remain holdouts who complain that the ACA is an infringement of 'freedom.' That's true only under a bizarro-world definition of 'freedom.' Before the ACA, Americans were 'free' to be locked into jobs they detested; to be abused, ripped off or rejected outright by insurance companies; and to suffer medical conditions without treatment.

The ACA hasn't changed every aspect of that in a single year, and its ability to meet all of its goals remains conjectural. But so far it has pointed the way to a better--yes, radically better--system of American healthcare."

Phil Schiliro, JD, former Director of White House Legislative Affairs and Special Adviser to President Barack Obama, stated in his Mar. 24, 2014 article for Politico titled "The Affordable Care Act Is Working":

"It is now four years since the Affordable Care Act was enacted. And in more than 30 years in government, I've never seen a law get so little recognition for doing so much good so quickly.

The right measure of the ACA isn't whether it avoids political controversy; it's whether it makes America better by achieving its five most fundamental goals: expanding health-insurance coverage, lowering costs and promoting fiscal responsibility, increasing quality through innovation, protecting seniors and delivering peace of mind to American families by guaranteeing essential rights in dealing with insurance companies.

By that standard the law is already a success. Health insurance has expanded. More than 5 million Americans have signed up for coverage through federal and state marketplaces; millions have been determined eligible for Medicaid or the Children's Health Insurance Program; and 3 million young adults gained insurance through their parents' coverage. Even more compelling than statistics are the letters hard-working Americans are sharing with the president. Their unscripted and private testimonials are building a lasting record of the life-changing—and often lifesaving—impacts the ACA is having."

The American Medical Association stated, in an unpublished July 6, 2012 Letter to the Editor of the Wall Street Journal written by then-AMA President Jeremy A. Lazarus, MD, titled "AMA to Wall Street Journal: AMA Support of Affordable Care Act," available at

"While the [Affordable Care Act]... is not perfect, the AMA, the nation's largest physician organization, supported it because it makes necessary improvements to our health care system. We are pleased the law expands coverage to millions of uninsured who live sicker and die younger than those with insurance. It allows physicians to see patients earlier before care is more expensive, provides funding for research on drugs and treatments, increases Medicare and Medicaid payments for primary care physicians and includes Medicare bonus payments for general surgeons in underserved areas."

Steven Rattner, Wall Street financier, stated in his Feb. 21, 2015 op-ed for the New York Times titled "For Tens of Millions, Obamacare Is Working":

"Ever since President Obama unveiled his health care plan in 2009, critics have questioned its lofty promise to bring affordable health insurance to millions of Americans.

Now statistics for the second year are largely in hand and the verdict is indisputable: Its disastrous 2013 rollout notwithstanding, the Affordable Care Act has achieved nearly all of its ambitious goals.

Most important, just three key provisions — creation of exchanges with subsidies for those who qualify, expansion of Medicaid and minimum standards for insurance plans — have benefited at least 31 million Americans.

Millions more have taken advantage of other features, such as the inability of insurance companies to deny coverage based on pre-existing conditions and the ability to include children up to age 26 in a parent's plan."

AARP (formerly the American Association of Retired People) stated in a June 28, 2012 press release titled "AARP Responds to Supreme Court Ruling on the Affordable Care Act," available at

"This landmark legislation [the ACA] is already improving the health and financial security of our members and all Americans.

AARP supported this law because it helps many Medicare recipients avoid financially burdensome increases in prescription drug costs by closing the Medicare prescription drug coverage gap, or 'doughnut hole.' The ACA also expands the number of people eligible for free preventive and wellness benefits, and cracks down on Medicare fraud, waste and abuse. Finally, for those not yet eligible for Medicare, the ACA will be instrumental in eliminating discriminatory health insurance practices such as exclusions based on pre-existing conditions, and in limiting the use of age rating to charge exorbitant premiums for older Americans.

By starting to close the doughnut hole, 5.3 million people with Medicare Part D have saved $3.7 billion since the law was enacted. In the first five months of 2012, 745,000 people with Medicare saved a total of $485.3 million on prescription drugs in the doughnut hole coverage gap for an average of $651 in savings per person this year. Over 32.5 million Americans in Medicare used one or more free preventive services in 2011. And, over 2.2 million people with traditional Medicare benefited from the new Annual Wellness Visit in 2011."

USA Today stated in its Dec. 11, 2013 editorial titled "Obamacare Remains Worthy: Our View":

"Until now, the law's benefits have been mostly theoretical. But as more and more people select plans, the reasons Obamacare is necessary are becoming real:

• While people whose insurance is changing are inconvenienced, those who could never get insurance because of pre-existing conditions or the inability to pay are getting it, thanks to subsidies and an end to insurers' ability to turn people away.

• The insurance people are getting is substantial, not the flimsy policies that, for example, offered discounts on doctor visits but wouldn't cover a single minute in a hospital.

• Annual and lifetime insurance limits that bankrupted people with major illnesses or parents of chronically ill children are gone.

• Also gone is the ability of insurers to take away coverage when people really need it, on the pretext that they hadn't disclosed some minor condition from years earlier."

The American Academy of Family Physicians (AAFP) stated in its "Overview" of the Patient Protection and Affordable Care Act, available at (accessed Apr. 24, 2015):

"The Patient Protection and Affordable Care Act (ACA) represents a significant shift in health care in the United States. Support for the legislation, now public law, is consistent with advocacy principles adopted by the AAFP Congress of Delegates in October 2009.

Specifically, the Patient Protection and Affordable Care Act:

• Guarantees coverage and expands access to health care for 32 million Americans;
• Helps shift the United States toward a health care delivery system based on primary care by increasing payment for primary care services and other measures;
• Advances the principles of the Patient Centered Medical Home;
• Invests in training more family physicians;
• Eliminates many of the worst practices of the health insurance industry, such as dropping patients when they get sick or denying coverage because of pre-existing conditions."

Mike Kreidler, MPH, Insurance Commissioner for Washington state, wrote in a Mar. 1, 2015 op-ed for the Seattle Times titled "Fix but Don't Jettison Affordable Care Act":

"[E]ven opponents cannot deny that the law is providing long-overdue protections and affordable coverage to millions of people. Insurers can no longer refuse you coverage if you are sick. Insurers can no longer impose a lifetime limit on coverage just when you may need it most. Young people can stay on their parents' plans until age 26, a welcome support to many who are just entering adulthood.

In Washington state, we have seen a 50 percent increase in the number of insurers entering the health-insurance market since the law took effect. They currently offer 230 plans. The average premium increase of just 2.3 percent in 2014 is the lowest in almost a decade. And the uninsured rate has plunged by nearly 40 percent — meaning almost 400,000 more people have coverage, many for the first time in their lives."

Sally Kohn, JD, CNN political commentator, stated in her May 28, 2014 article for titled "317 Million Reasons to Love Obamacare":

"[T]here are millions [of] reasons to celebrate Obamacare...

317 million

-- That's how many Americans — i.e., all of us — potentially benefit from the requirement that insurance companies provide flu shots, HIV screenings, prostate exams, mammograms and FDA-approved contraception for free, without a co-pay.

-- Plus, we all benefit from new requirements that insurance companies must spend at least 80% of our premium dollars on our health care as opposed to marketing or administration.

-- We all benefit from the new requirement that insurance companies publicly justify their actions if they want to raise premiums by 10% or more.

-- We all benefit from knowing that our insurance can now never be capped or canceled at the whim of insurance companies...

Every day, as we all see the benefits of health care reform in our lives, support for Obamacare will grow stronger. Before long, not even the most partisan Republicans will be able to attack it."

CON (no)

John P. Geyman, MD, Professor Emeritus of Family Medicine at the University of Washington School of Medicine, stated in his article titled "A Five-Year Assessment of the Affordable Care Act: Market Forces Still Trump the Common Good in U.S. Health Care," published in the Apr. 2015 issue of the International Journal of Health Services:

"The Affordable Care Act (ACA) was enacted in 2010 as the signature domestic achievement of the Obama presidency. It was intended to contain costs and achieve near-universal access to affordable health care of improved quality. Now, five years later, it is time to assess its track record… Based on the evidence, one has to conclude that containment of health care costs is nowhere in sight, that more than 37 million Americans will still be uninsured when the ACA is fully implemented in 2019, that many more millions will be underinsured, and that profiteering will still dominate the culture of U.S. health care…

The ACA built upon the flaws of our market-based system and, quite predictably, is failing to contain costs and provide broad access to affordable, quality health care. Corporate interests still trump the common good in U.S. health care. More fundamental reform is required based upon universal access to health care as a right… Until that happens, we can expect continued turmoil and increasing public backlash to a dysfunctional system that places profits over service. It is just a matter of time before the country will be forced to choose between discredited, deregulated markets and a more efficient single-payer system that ensures access to essential health care for all Americans."

Jeffrey A. Singer, MD, Adjunct Scholar at the Cato Institute, stated in his Oct. 15, 2014 op-ed for The Hill titled "Why Doctors Give Obamacare a Failing Grade":

"Count me among the discontented. Obamacare has harmed too many of my patients.

It has done so by disrupting the doctor-patient relationship and thereby worsening the quality of patients' care. This is the heart and soul of medicine, as I have learned in in my 33 years as a practicing physician...

Obamacare's assault on the doctor-patient relationship first manifested this time last year, when my patients began receiving cancellation letters indicating that their plans didn't meet the law's minimum requirements...

Nor does it appear that any thought was given to the regulatory burden that Obamacare has imposed on physicians. In their zeal to regulate and standardize health care, the law's authors empowered bureaucrats in Washington to drown doctors like me in a deluge of paperwork and reporting requirements.

This has only forced doctors like me to spend less time treating patients. Compared to when Obamacare was passed, I now spend roughly half my time on data entry and administrative work. I feel more like a data entry clerk than a doctor. Surely this time would be better spent in the treatment room or on the phone with patients conducting follow-ups."

Mitch McConnell, JD, US Senate Majority Leader (R-KY), stated during a Jan. 25, 2015 interview with 60 Minutes' Scott Pelley, available at

"Obamacare is the single worst piece of legislation that's been passed in the last half-century. The biggest step in the direction of turning us into a European-type country…

The Congressional Budget Office, [which] doesn't work for Republicans or Democrats, run by a former Clinton staffer, said that the best case scenario, Obamacare reduces the number of uninsured from forty million to thirty million. A twenty-seven hundred page bill that wreaks havoc with the private health insurance market, and in the end, doesn't get everybody covered in the first place. Now that is not my view of how to improve the American health care delivery system. If we had the ability to do it, we ought to pull it out root and branch and start over."

John Boehner, Speaker of the US House of Representatives, stated during a Jan. 25, 2015 interview with 60 Minutes' Scott Pelley, available at

"Obamacare is costing jobs in America, it's raising costs for American families, and it's destroying the doctor-patient relationship. I think it's the wrong prescription...

When you look at Obamacare it's a perfect example of what Washington does. It's a one size fits all approach for the whole country. All driven by Washington bureaucrats... I bet they've hired tens of thousands of people, between the IRS and over at Health and Human Services, just to run this. All the decisions, all the rules, decided by Washington. We have a wide, diverse country, and I just think it's time for us to look at this differently. For those who don't have access to affordable health insurance, the helping those at the bottom, I think we're all for. But we don't need Washington to ruin the best health care delivery system the world has ever known."

Michael Moore, documentary filmmaker, stated in his Dec. 31, 2013 op-ed for the New York Times titled "The Obamacare We Deserve":

"Obamacare is awful.

I believe Obamacare's rocky start — clueless planning, a lousy website, insurance companies raising rates, and the president's telling people they could keep their coverage when, in fact, not all could — is a result of one fatal flaw: The Affordable Care Act is a pro-insurance-industry plan implemented by a president who knew in his heart that a single-payer, Medicare-for-all model was the true way to go. When right-wing critics 'expose' the fact that President Obama endorsed a single-payer system before 2004, they're actually telling the truth.

By 2017, we will be funneling over $100 billion annually to private insurance companies. You can be sure they'll use some of that to try to privatize Medicare.

For many people, the 'affordable' part of the Affordable Care Act risks being a cruel joke. The cheapest plan available to a 60-year-old couple making $65,000 a year in Hartford, Conn., will cost $11,800 in annual premiums. And their deductible will be $12,600. If both become seriously ill, they might have to pay almost $25,000 in a single year."

Paul Ryan, US House Representative and Chairman of the House Ways and Means Committee, stated in his Jan. 6, 2015 op-ed for USA Today titled "Rep. Paul Ryan: Obamacare Is Beyond Repair":

"You can't fix a fundamentally broken law; you've got to replace it. That's why Congress can't save Obamacare with a few tweaks, despite what its defenders say. No quick fix can correct the main flaw: The law takes power away from patients and hands it to bureaucrats.

As millions of Americans have learned from their cancellation notices, Obamacare lets bureaucrats decide what insurance plans must cover. It buries doctors and hospitals in red tape. And it adds a whole host of new taxes and fees that drive up the cost of care. The law doesn't make people's health care decisions any easier; in many cases, it makes those decisions for them.

But the law's effects go far beyond the doctor's office, weighing down our economy and discouraging hiring. The law requires employers with more than 50 full-time employees to give them health insurance. But because the law defines 'full time' as 30 hours or more, employers are keeping employees below that threshold to avoid the mandate entirely."

Robert Zarr, MD, President of Physicians for a National Health Program, stated in his Mar. 4, 2015 article titled "The Obamacare Challenge We Need? Improved, Expanded Medicare for All," posted on the Common Dreams website:

"[T]he sad reality is that the ACA won't be able to achieve universal coverage. It won't make care affordable or protect people from medical bankruptcy. Nor will it be able to control costs.

The ACA is fundamentally flawed in these respects because, by design, it perpetuates the central role of the private insurance industry and other corporate and for-profit interests (e.g. Big Pharma) in U.S. health care."

Ted Cruz, JD, US Senator (R-TX), stated in his Dec. 11, 2013 op-ed for USA Today titled "Obamacare is a Disaster: Ted Cruz":

"Today, there can be no dispute that Obamacare is a disaster.

The reason Obamacare is failing is not its bungled website. It is because Americans are now seeing the fundamental trade-off behind the law — that in order to insure a relatively small number of the uninsured, many millions more Americans are likely to lose their private insurance, lose access to preferred doctors, or pay substantially more for their insurance.

President Obama promised that if this law was passed, you could keep your plan, you could keep your doctors, and your premiums would go down. Each of those promises has proved false.

Already, more than 4 million people have lost their insurance plans because of Obamacare. And millions more Americans' health insurance is at risk. Some experts predict anywhere from 80 million to 129 million private health plans will be canceled or forcibly changed over the next year...

The president promised that the average family's premiums would fall by $2,500; instead, they have risen by over $3,000 since 2008...

Moreover, Obamacare is a major jobs killer, especially for those struggling to climb the economic ladder. Workers are seeing their hours cut, and small businesses are unable to hire new employees."

Jim Sensenbrenner, JD, US Representative (R-WI), stated in his Nov. 25, 2014 column titled "Second Open Enrollment Period, Obamacare Still a Disaster," posted on his website:

"Under the Affordable Care Act our health care system is nothing short of a disaster and coverage is far from 'affordable.'...

Thousands of Americans are being told they must switch doctors and providers to comply with coverage regulations, while hundreds of employers are worried about restricting hiring practices and lowering employees' hours to comply with the pending employer mandate. As of September 2014, at least 10 employers with over 50 full-time employees in Wisconsin have already cut hours of part-time workers to avoid the 30-hour-per-week threshold that requires them to provide coverage under the employer mandate.

By reducing competition and limiting patient choice, insurance and health care providers have little incentive to lower costs or increase the quality of care under Obamacare. The American people end up paying more and getting less."

Thomas P. Miller, JD, Resident Fellow at the American Enterprise Institute (AEI), Grace-Marie Turner, President of the Galen Institute, and James C. Capretta, MA, Senior Fellow at the Ethics and Public Policy Center, stated in their Apr. 25, 2012 article titled "Why the (Un)Affordable Care Act Should Be Repealed and Replaced," published in the May 2012 issue of the American Journal of Medicine and available at

"[W]e strongly recommend that the Affordable Care Act of 2010 should be repealed and replaced as soon as possible. The Affordable Care Act (ACA) has become deservedly more unpopular since its enactment. It is too costly to finance, too difficult to administer, too burdensome on health care professionals, and too disruptive of existing health care arrangements that many Americans prefer. It will limit future economic growth, distort health care delivery, exacerbate already-unsustainable entitlement spending, and erase any meaningful constitutional limits on the enumerated powers of the federal government. By relying on illusory formulaic reductions in future payments to physicians, on burdensome new reporting requirements, and on top-down restrictions on medical innovation, it will further jeopardize access to quality care...

[A] clear plurality of Americans opposes the ACA and particularly its unprecedented individual mandate to purchase health insurance... [T]he overall structure of over-regulated, over-subsidized, and centrally-planned health care that the new health law aims to implement remains unaffordable, unworkable, and unsustainable. Its early results are designed to be inconclusive because the ACA's essential features will not be fully implemented for several more years. But they promise to be both disappointing and destabilizing across the entire health care system and our overall economy. We cannot afford to waste additional years heading in the wrong direction. The sooner that the ACA is repealed and replaced, the earlier we can get back to the urgent need to reform the US health care system more effectively and sustainably."

A group of 200 economists, including current and former officials at the Congressional Budget Office (CBO), Office of Management and Budget (OMB), and White House Council of Economic Advisors (CEA), stated the following in a Jan. 18, 2011 letter to House Speaker Boehner, House Minority Leader Pelosi, Senate Majority Leader Reid, and Senate Minority Leader McConnell, available at the American Action Forum website:

"To promote job growth and help to restore the federal government to fiscal balance, we, the undersigned, feel that it would be beneficial to repeal and replace the Patient Protection and Affordable Care Act (P.L. 111-148). Too many Americans remain unemployed and the United States faces a daunting budgetary outlook. We believe the Patient Protection and Affordable Care Act is a threat to U.S. businesses and will place a crushing debt burden on future generations of Americans...

The Patient Protection and Affordable Care Act contains expensive mandates and penalties that create major barriers to stronger job growth... The law also levies roughly $500 billion in new taxes that will enter the supply chain for medical services, raising the cost of medical services... these medical costs will translate to higher insurance premiums, further increasing the cost of operating a business in the United States...

The Patient Protection and Affordable Care Act does not constitute real health care reform... Congress should start with a clean sheet of paper and adopt initiatives that would encourage providers to offer higher-quality care at lower costs; reduce the cost pressures that threaten to bankrupt Medicare and Medicaid; and give every American access to more options for quality insurance."

Janice Shaw Crouse, PhD, Senior Fellow at the Concerned Women for America (CWA), Beverly LaHaye Institute (BLI) and former speechwriter for US President George H. W. Bush, wrote in her Mar. 26, 2010 article "What You Get with Free Health Care," available at

"Congressional Democrats, disregarding the will of the people and dressing their action in high-sounding rhetoric, rammed through Congress their unpopular and disastrous plan for 'transforming' America into a Cuban, British, Canadian or French image...

[I]n those countries where massive government intervention has replaced free market enterprise, the reality is far short of the utopian promises and the policies that have been spun out so recklessly and misleadingly. Price controls, inevitably, limit innovation. If that happens to medical research and technological advancement, the results will be disastrous.

Everybody wants affordable, accessible, and high-quality health care; there are proposals on the table for changes that would make significant improvements in those aspects of U.S. health care. Those proposals would unleash free market competition, improve quality, and lower costs for health care in the same way that it has done for other national industries and businesses...

But cost control is not the purpose of ObamaCare. ObamaCare is all about redistributing wealth and putting a vast segment of the economy under bureaucratic control...

Under ObamaCare, Uncle Sam becomes Santa Claus. But sooner or later, the bills come in and all those 'gifts' turn out to be pretty expensive after all."