51:4 Evaluating the Affordable Care Act: The Eye of the Beholder

Abstract

This Article begins with the ACA’s core goal of guaranteeing the availability of insurance coverage and then considers the goal of making insurance affordable. The final Part examines some potential unintended consequences. The Article concludes by noting that, although it is too early to determine the ACA’s ultimate performance, the variety of approaches to implementation in different states creates a complex but convenient natural experiment that should reveal whether health care access and consumer protections improve or worsen in states that fully embrace the law as compared to states that actively oppose it. That real-world test should prove to be the best evidence of whether the ACA’s supporters or detractors are on firmer ground.