Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Doctor accepting new patients
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

How should we define the success of the Affordable Care Act?

Brad Wright, PhD
Policy
January 15, 2014
Share
Tweet
Share

In recent months, news reports focused on the number of new enrollees as a key test of the law. Although the troubled performance of the Healthcare.gov website during October and November delayed enrollment for hundreds of thousands of potential subscribers, Obama administration officials and congressional Democrats hailed a surge in enrollment at the end of the year as proof that the law would fulfill its promise of providing affordable coverage to millions of uninsured Americans.

To date, enrollment numbers paint a decidedly mixed portrait of the ACA’s impact.

Speaking on September 30, 2013, HHS Secretary Kathleen Sebelius declared that “success looks like at least 7 million people having signed up by the end of March 2014.”

By late December, however, Sebelius hailed the fact that 2.1 million people had signed up for coverage through the new exchanges as evidence that the law was now working well.

Earlier in the month, President Obama cited the increased pace of enrollment as proof that “the demand is there, and the product is good.” Even the most optimistic estimates, however, suggest that signups continue to lag far behind the administration’s own goals.

Obama administration officials responded to criticism about the widespread cancellation of individual insurance market policies in late 2013 by exempting millions of Americans who faced “unexpected natural or human-caused events” that prevented them from obtaining coverage from the individual mandate.

Ironically, this decision, which sought to mollify congressional critics and their outraged constituents, further undermines the prospects for meeting its enrollment targets and exacerbates an already serious credibility gap for Democratic candidates in the upcoming congressional elections. Democrats continue to emphasize a “moving average” approach to measuring the success of the health insurance exchanges, pointing out that the pace of enrollments increased steadily once the website’s “glitches” were ironed out in late November.

However, a failure to meet the administration’s own goal of 7 million new enrollees by the end of March 2014 will provide Republicans with a new policy story just in time for the 2014 campaign season.

Unfortunately for congressional Democrats, increased enrollments did little to rehabilitate the image of the ACA in the eyes of the public. In a CNN poll released in on December 23, support for the law fell to 35% — a new low — despite significant improvements to Healthcare.gov as a result of the “tech surge” in late November. The new polls highlight a troublesome trend for Democratic candidates who heed President Obama’s call to close ranks behind the ACA. Core Democratic constituencies now oppose the law, including 60% of women.

Furthermore, in an ironic twist, 63% of those polled expected to pay more for health care after the implementation of the Affordable Care Act. In its current form, the ACA promises to be a millstone around the necks of vulnerable congressional Democrats in 2014. Unless the Obama administration and other supporters of reform can reassure a doubtful public about the problem-solving capacity of American political institutions, the ACA may prove to be a classic pyrrhic victory.

In short, administration officials may win small battles over improving the performance of website, but lose the larger war over public support for government-led health care reforms.

The continued unpopularity of Obamacare more than three and a half years after its enactment reflects a much deeper concern than simply website snafus or insurance cancellations. As I’ve argued elsewhere, Obamacare has done little to restore public faith in the ability of government to solve social problems. Unless and until the administration begins to meet its own targets, the political fallout of the ACA will cast a long shadow over the 2014 elections … and beyond.

Brad Wright is an assistant professor of health management and policy, University of Iowa who blogs at Wright on Health.

ADVERTISEMENT

Prev

What truly counts in medicine isn’t easy to measure

January 15, 2014 Kevin 13
…
Next

What I'm looking for in a personal health record system

January 15, 2014 Kevin 1
…

Tagged as: Obama, Primary Care, Public Health & Policy

< Previous Post
What truly counts in medicine isn’t easy to measure
Next Post >
What I'm looking for in a personal health record system

ADVERTISEMENT

More by Brad Wright, PhD

  • If your hospital closes, does patient care suffer?

    Brad Wright, PhD
  • a desk with keyboard and ipad with the kevinmd logo

    We have the power to prevent disease. But we’re not using it.

    Brad Wright, PhD
  • a desk with keyboard and ipad with the kevinmd logo

    The uninsured rate has fallen, but it may soon rise

    Brad Wright, PhD

More in Policy

  • Why Filipino nurses faced higher COVID-19 mortality rates

    Joaquim Diego Santos
  • The health insurance crisis 2026: What Kentuckians need to know

    Susan G. Bornstein, MD, MPH
  • Health insurance waste: Why eliminating the middleman saves billions

    Edward Anselm, MD
  • Why AAP funding cuts threaten the future of pediatric health care

    Umayr R. Shaikh, MPH
  • Why private equity is betting on employer DPC over retail

    Dana Y. Lujan, MBA
  • Why PBM transparency rules aren’t enough to lower drug prices

    Armin Pazooki
  • Most Popular

  • Past Week

    • My wife’s story: How DEA and CDC guidelines destroyed our golden years

      Monty Goddard & Richard A. Lawhern, PhD | Conditions
    • Why medical school DEI mission statements matter for future physicians

      Aditi Mahajan, MEd, Laura Malmut, MD, MEd, Jared Stowers, MD, and Khaleel Atkinson | Education
    • Breaking the silence: mental health and racism in medical school

      Michael F. Myers, MD | Physician
    • Health insurance waste: Why eliminating the middleman saves billions

      Edward Anselm, MD | Policy
    • Why AI in health care is the only fix for physician shortages

      John C. Hagan III, MD | Physician
    • High-protein diet risks: Why more isn’t always better

      Farid Sabet-Sharghi, MD | Conditions
  • Past 6 Months

    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • A physician father on the Dobbs decision and reproductive rights

      Travis Walker, MD, MPH | Physician
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
  • Recent Posts

    • Teaching joy transforms the future of medical practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Filipino nurses faced higher COVID-19 mortality rates

      Joaquim Diego Santos | Policy
    • Frailty and functional decline: Why diagnosis is not enough

      Gerald Kuo | Conditions
    • Moral injury in medicine: When silence becomes a survival strategy

      Timothy Lesaca, MD | Physician
    • Iterative mindset versus AI and GLP-1s: Why shortcuts weaken the brain

      Martha Rosenberg | Tech
    • Autism comorbidities: the hidden link between POTS, GI issues, and hypermobility

      Carrie Friedman, NP | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • My wife’s story: How DEA and CDC guidelines destroyed our golden years

      Monty Goddard & Richard A. Lawhern, PhD | Conditions
    • Why medical school DEI mission statements matter for future physicians

      Aditi Mahajan, MEd, Laura Malmut, MD, MEd, Jared Stowers, MD, and Khaleel Atkinson | Education
    • Breaking the silence: mental health and racism in medical school

      Michael F. Myers, MD | Physician
    • Health insurance waste: Why eliminating the middleman saves billions

      Edward Anselm, MD | Policy
    • Why AI in health care is the only fix for physician shortages

      John C. Hagan III, MD | Physician
    • High-protein diet risks: Why more isn’t always better

      Farid Sabet-Sharghi, MD | Conditions
  • Past 6 Months

    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • A physician father on the Dobbs decision and reproductive rights

      Travis Walker, MD, MPH | Physician
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
  • Recent Posts

    • Teaching joy transforms the future of medical practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Filipino nurses faced higher COVID-19 mortality rates

      Joaquim Diego Santos | Policy
    • Frailty and functional decline: Why diagnosis is not enough

      Gerald Kuo | Conditions
    • Moral injury in medicine: When silence becomes a survival strategy

      Timothy Lesaca, MD | Physician
    • Iterative mindset versus AI and GLP-1s: Why shortcuts weaken the brain

      Martha Rosenberg | Tech
    • Autism comorbidities: the hidden link between POTS, GI issues, and hypermobility

      Carrie Friedman, NP | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

How should we define the success of the Affordable Care Act?
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...