Jan 11, 2020
category: Law


“Obama Care” or The Patient Protection and Affordable Care Act (ACA) is a special complex of acts and rules, signed by President Barack Obama in 2010. It is one of the most significant US federal statutes, regulating the situation with the healthcare in the state. The main purpose of this act is to increase the availability of health insurances for all social groups by lowering costs and expanding private and public insurance coverage. Nevertheless, the main question, which concerns almost every the US citizen is its actual effectiveness. To find out whether it is effective or not, it is necessary to analyze the main goals of its reforms and find out whether they are achieved on the example of a concrete state.

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Main Reforms of ACA

The ACA incorporates a number of reforms related to public health, focusing mainly on improving access to effective prevention services. The first of it is organizational reform. The greatest achievement of this reform is the creation of two new bodies such as a Preventive Services Task Force and a National Prevention, Promotion, and Public Health Council within the Department of Health and Human Services. The main objective of the first organization is to evaluate the cost–effectiveness of preventive services. The main objective of the second organization is to make recommendations for a national prevention and health promotion funding and strategy. The second reform is funding reform. According to it, a Prevention and Public Health Fund has been created. The government has allocated 1250$ from 2010 to 2011. Thus, funding reform creates perfect condition for allocating and controlling resources of Health Care for the whole country as well as its separate states. The third reform is insurance reform. It addresses the demand for public health services by eliminating financial barriers to preventive services. The main goal of it is to form a qualitative health care available for everyone. The fourth reform is the one connected to human resources management. According to it, ACA’s main goal is to increase primary care capacity. For it, in 2010, half of the $500 million fund was given to support primary care by funding residency program capacity, physician assistant training, and nurse practitioner–led clinics. The last reform is the one in the sphere of infrastructure. It deals with investment in modernizing outdated public health information technology, laboratory capacity, and surveillance (Hardcastle, et al., 2011, p. 323).

Evaluation of Reforms’ Effectiveness

For evaluation of the reforms’ effectiveness, which build the ACA, we have chosen North Carolina. Firstly, funding reform helps to allocate health care resources and distribute them among the population, taking into consideration its needs. For example, North Carolina is awarded the grant, which is used to improve access to healthy eating and physical activity, promoting tobacco – free living, and encouraging preventive and primary care for diabetes and hypertension (Randolph & Morrow, 2013, p. 330 – 331). As North Carolina’s society suffers from bad habits and unhealthy lifestyle, the current goal of the ACA in this state is “to decrease chronic diseases by making the healthy choice the easy choice” (Randolph & Morrow, 2013, p. 331). Secondly, the reform in the sphere of human resource management also has a great positive impact on the health of the population in North Carolina. It has provided QI training and QI support to health care workers. It has resulted in substantial improvements of quality services and generation of $4,8 million in cost savings for the citizens of North Carolina. Thirdly, the reform in the sphere of infrastructure has also contributed to improving the health and convenience of North Carolina’s population. For example, NPHII program has helped to increase productivity of Vital Records Special Registration Unit by 97%. It leads to reducing the waiting time of patients for special record requests. Finally, organizational reform has contributed to close collaboration between different bodies in the system of health care (Randolph & Morrow, 2013, p. 331). For example, “in 2011 the State Health Director and the President of the North Carolina Hospital Association sent a joint letter to all hospital chief executive officers and public health directors to encourage them to collaborate on CHNA efforts” (Randolph & Morrow, 2013, p. 331). Thus, it becomes clear that, in general, the ACA has a positive influence on the USA population, as it provides it with necessary resources to achieve qualitative health care, professional health workers, improved technologies, and different services.

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Nevertheless, the analysis also helps to find out some drawbacks of the ACA. Although, it tries to make health care available for different groups of people; in many cases, it deprives the population of this opportunity. It occurs because the government decreases the number of health care workers to cover the payment for insurances of vulnerable groups of the population. It is estimated that such strategy will lead to a shortage of 52, 000 primary care physicians by 2025. It will leave many Americans without access to healthcare. In addition, if pharmaceutical companies pay an extra $84, 8 billion to close the “donut hole” in Health Care, it will lead to significant increase of drug costs for the general population (Supplement Health Care, 2012). In such a way, health care available for everyone may remain only in people’s dreams.


To sum up, the analysis of the ACA implementation in the North Carolina shows that it brings many benefits for the society through its organizational, funding, insurance, human resources, and infrastructure reform. In general, the ACA has a positive influence on the USA population, as it provides it with necessary resources to achieve qualitative health care, professional health workers, improved technologies, and different services. Nevertheless, the general drawbacks of it should also be taken into consideration. They are shortage of health care workers and possible rising of drug costs. Nevertheless, as for me, they will be eliminated soon, as the ACA is a new program and it requires time to develop methods of control and anticipation.

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