The Affordable Care Act at Six: Reaching for a New Normal

• Published in: The Journal of law, medicine & ethics medicine & ethics, 2016-12, Vol.44 (4), p.533-537
• Main Authors: Rosenbaum, Sara, Thorpe, Jane Hyatt
• Format: Article
• Language: English
• Subjects: Architects; Government spending; Health; Health care policy; Health insurance; Health technology assessment; Insurance coverage; Legal reform; Nominations; Patient Protection & Affordable Care Act 2010-US; Presidential elections
• ISSN: 1073-1105; 1748-720X
• DOI: 10.1177/1073110516684781

In 2008, on the eve of health reform, the Journal of Law Medicine & Ethics published a special national health reform issue, guest edited by Sara Rosenbaum and Jeanne Lambrew. The guest authors for that special edition discussed many aspects of the challenge confronting the nation that ultimately would move front and center during the debate and enactment of the law. Jeanne went on to become one of the principal architects of the law and its implementation.This special issue of JLME assesses the Affordable Care Act (ACA) at six years and looks to the future in this most extraordinary of election years. This time Sara is joined by Jane Hyatt Thorpe, her long-time colleague and an expert on health information and law. Our authors include some of the experts who wrote in 2008, who now are joined by other luminaries in the field of health law and policy.This volume of essays has proven to be at least as challenging as the 2008 collection. So much has been accomplished in the realm of health care, and yet much work is needed to make the law function at its full potential. The path forward remains uncertain because of the virulent political climate that continues to surround the law, intensified by a singularly ferocious and unpredictable 2016 presidential election.The nation is fast approaching a watershed presidential election that presents two fundamentally different views about the future of health reform. Democratic presidential nominee Hillary Clinton would improve and strengthen the ACA, while at the same time seeking pragmatic solutions that would calm the choppy waters that continue to surround the law. Republican Presidential nominee Donald Trump appears to embrace the Republican orthodoxy of repeal and replace which, as Drew Altman of the Kaiser Family Foundation notes, would move toward less generous private insurance and reduced government spending on public coverage.1At this momentous point, it is worth looking back on the ACA's accomplishments, while also focusing on the challenges going forward, as this issue's authors have done with enormous skill.