How should the Affordable Care Act be modified?

The Affordable Care Act is perhaps the biggest overhaul of the U.S. health care system in many decades. Enacted by President Barack Obama in 2010, it made health care attainable and affordable to millions of Americans. Individuals with pre-existing medical conditions cannot be denied health care coverage; insurance companies have to cover essential health care needs including mental health and preventive services, children can be covered under their parents’ plans until age 26, and indigent customers can have subsidies to cover insurance costs.

However, there are certain groups who not covered under this act, most notably illegal immigrants. Although everyone can get emergency care in the U.S., people who are uninsured are not able to get many basic health care needs, including preventive screenings and medication coverage.

As a resident physician, I’ve seen too many cases of uninsured patients brought into the emergency room with heart attacks and strokes as results of highly preventable and treatable medical comorbidities like diabetes and high cholesterol. Another criticism is that paradoxically, some Americans may end up paying more for their insurance premiums.

Come January, the health care system will be revamped again. Although President-elect Donald Trump has vowed to originally scrap the ACA altogether, he may be less decisive about that now. Donald Trump initially stated verbatim on his website: “As it appears Obamacare is certain to collapse of its own weight, the damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next president and a Republican Congress lead the effort to bring much-needed free market reforms to the health care industry. But none of these positive reforms can be accomplished without Obamacare repeal.”

What Mr. Trump plans to do with the health care system remains nebulous. Although it may not be prudent to ax the Affordable Care Act altogether, modifying it can be beneficial. I agree with his view that increasing the number of insurance options and the resulting competition will further drive prices down for consumers. However, many are worried about how our future president’s outspoken views on illegal immigrants will affect the rights of these people to get basic health care or if they will even receive emergency care. Or whether his stance on abortion will impact women’s access to emergency contraception and other reproductive services.

America is indeed a great country, made up of a diverse population of people from different racial, religious, and socioeconomic backgrounds. What we all share are our humanity and our vulnerability to medical and psychiatric ailments that affect our quality of life and lifespan. Thus, it is imperative that everyone living in America has equal access to affordable and quality health care.

The author is an anonymous medical resident.

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