Beyond Coverage — What It Will Take to Fix American Health Care

The Affordable Care Act (ACA) fundamentally changed American health care — expanding coverage, establishing consumer protections that are now broadly expected, and helping cement the idea that access to health care is a basic human need rather than a privilege tied to health status, gender or income. The next challenge is no longer just whether people have coverage, but whether they can afford to get it , keep it and use it. Rising premiums, deductibles, cost-sharing and administrative barriers are straining people across Medicaid, the ACA Marketplaces, Medicare and employer-sponsored insurance. Fixing American health care will require looking across the whole system: reducing friction for patients and providers, rebuilding a durable federal floor for coverage and access, resisting efforts to retreat to a pre-ACA coverage framework, supporting state innovation , and accepting that meaningful reform will require mutual sacrifice across the health care ecosystem. The challenge before us is creating a health care system that is affordable, usable and sustainable for patients, providers, employers and taxpayers alike — wherever they live and whatever their income, gender, race or age. We have a great deal of work to do. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit 80million.substack.com