Patient Protection and Affordable Care Act (ACA) advocacy
The Patient Protection and Affordable Care Act (ACA) has transformed access to health care in this country.
A popular, successful law, it is consistent with two core AAFP tenets: that health is a basic human right, and that the U.S. health care system should center on primary care.
Why the ACA matters to family physicians
Because the ACA has shepherded the health care system toward primary care, the Academy has supported the law from its inception and backed it across numerous legal challenges.
In its first decade, the ACA yielded significant policy wins for family physicians, including:
Increased payment rates for primary care physicians who accept Medicaid or work in rural areas
Investment in the Teaching Health Center Graduate Medical Education program to support training for more primary care physicians
Improving coordinated care by advancing the principles of the Patient Centered Medical Home
Key ACA provisions and protections for patients
In line with the AAFP’s principles and advocacy, the ACA’s consumer protections have eliminated many of the worst practices of the health insurance industry, such as charging more or denying coverage because of a preexisting health condition. The law also 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.
More than 54 million Americans have preexisting conditions that would likely have kept them from attaining health care coverage without the ACA.
ACA advocacy priorities for family physicians
Family physicians have seen firsthand the ACA’s profound effects on health care access.
Since the ACA’s enactment, the uninsured rate has dropped from 15.5%, in 2010, to less than 8%, in 2023. Thanks to this leap in coverage, family physicians have been better able to manage chronic conditions, prevent unnecessary emergency room visits and provide lifesaving interventions. At the same time, the ACA’s investment in primary care has reduced long-term health care costs for all Americans.
Despite this success, the ACA has faced steady political and legal opposition. These challenges to the law and the patients covered under it jeopardize:
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
The annual or lifetime cost limits afforded by the ACA
The Academy’s ACA advocacy persists because a primary-care–based system is essential to achieve improvements in access, quality and cost.
The Academy, backed by the collective voice of its chapters and members, continues to support the ACA and to urge congress and state lawmakers to safeguard its objectives.
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.
Recent AAFP communications
Joint communications with other organizations
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