The Patient Protection and Affordable Care Act — a law consistent with the AAFP principle that health is a basic human right — has transformed access to health care in the United States. Its consumer protections have eliminated many of the worst practices of the health insurance industry, such as charging more or denying coverage because of a pre-existing health condition. And it has prohibited health plans from putting annual or lifetime dollar limits on most benefits, while allowing families to cover their children until they turn 26.
Crucially, the ACA also has led the nation toward a health care delivery system based on primary care. It has increased payment rates for primary care physicians who accept Medicaid or work in rural area, invested in the Teaching Health Center Graduate Medical Education program to support training for more primary care physicians, and promoted better coordinated care by advancing the principles of the Patient Centered Medical Home.
The AAFP believes in a primary care–based U.S. health care system in which all people have appropriate and affordable coverage. This right is particularly vital to the more than 52 million Americans who have pre-existing conditions such as cancer, asthma, diabetes, high blood pressure and other serious or life-threatening chronic diseases -- a population that has inarguably benefitted from the Patient Protection and Affordable Care Act.
The Academy continues to support the ACA and to believe that Congress and state lawmakers must remain committed to safeguarding its objectives even if the law is undone by recent court challenges.
At risk: the coverage of some 30 million Americans, the tax structure that funds Medicare, protections for nursing mothers at work, affordable prescription drugs for seniors, enrollment in Medicaid and the Children's Health Insurance Program, and the loss of annual or lifetime cost limits afforded by the ACA.
The legal and political saga of the ACA demonstrates the urgent need for policy that furthers a primary care-based system is essential to achieve improvements in access, quality, and cost. Extensive worldwide research supports the value of such a framework, which has been shown to improve care access, quality and cost.
The United States will achieve the better health outcomes, higher patient satisfaction and more efficient use of resources known to result from a primary care-based system only by committing to health policy centered on family medicine.
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