Confused About The Affordable Care Act? You’re Not Alone.

If you are having trouble understanding the Affordable Care Act, rest assured you are among the majority of Americans. Too many catch phrases, too much partisanship, and too many pages to actually read and digest on your own.

The biggest problem for Americans when it comes to understanding the ACA is an abundance of false equivalencies. Too many interests, too many agendas, too many complicated terms. Let’s start to break it down using some hypothetical refrains you may hear:

1.) “The ACA Exchanges are not working, therefore the law isn’t working.”

The Department of Health and Human Services and the Obama administration urged the individual states to set up their own healthcare exchanges. To date, 16 states, including D.C., operate their own exchanges. Nineteen states have relegated all responsibility to the federally facilitated healthcare exchange ( The remaining states have some form of federal-state partnership.

2.) “People are not signing up, therefore the law isn’t working.”

A few weeks ago, the Department of Health and Human Services, the government agency responsible for the administration of the law, announced that approximately 106,000 Americans have signed up under the new law. Nearly 80,000 of those Americans signed up through state-run marketplaces, which are working more efficiently than the Federal system. States like Connecticut, Kentucky, California, and New York that have their own exchanges have seen lower costs and overall success under the law.

3.) “Some Americans have seen their plans cancelled, therefore the law isn’t working.”

Since the Affordable Care Act has gone into effect, insurance cancellation notices have gone out to many Americans. For some, this just happens with insurance. Most plans only last a year before both the insurer and patient have a choice to extend coverage. For many others, their plans do not meet the minimum qualifications set up by Obamacare. They may not offer coverage for things like maternity, preventive care without co-pays, or one of the Affordable Care Act’s 10 “essential benefits.”

As with every law, not all individuals can reap the benefits. Therefore, it is important to contrast anecdotal evidence with empirical data. Fifteen million Americans buy individual insurance (5% of the population). A few million have received cancellation notices, which by percentage is a low number.

4.) “Certain plans now cost more money, therefore the plan is not working.”

The law is predicated upon all Americans sharing a level playing field. It costs insurance companies more to cover individuals with pre-existing conditions, therefore the law contains a mandate for all individuals to be insured. The more healthy individuals signed up, the more the cost is shared. More signups equals lower premiums.

5.) “President Obama broke a promise about individuals keeping their plan, therefore the law isn’t working.”

President Obama and Congressional Democrats often used the line “If you like your plan, you can keep it, period.” Clearly, this was not true. But, the President announced that Americans will now be able to keep their canceled plans for a year.

Barack Obama


There is quite a bit to cover on this topic, and in no way have we covered all the bases. But in my opinion, the lesson here is this: nobody actually knows whether the law will work in the long run, but it is the law, and we need to at least give it a shot.


The views expressed in this piece are those of the writer and do not reflect the view of Sweet Lemon Media.

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1 Comment

  • Reply November 30, 2013

    Margaret Mulkerrin

    Great article Brandon! The law is too much for any one person, politician or citizen alike to understand. Articles like this help so much to bring an enormous piece of legislation in our life time, to an approachable setting. We will see the effects of this bill in our economic future, so it can’t hurt to better understand it.