4 key thoughts on opportunity under ACA

The future of the ACA may be uncertain, but with six years since its implementation in March 2010, it has already established itself as one of the most comprehensive overhauls of the U.S. healthcare system.

Daniel E. Dawes, an attorney and healthcare strategist, spoke with Becker's ASC Review about opportunities under the ACA, from physician incentives to public health. Mr. Dawes recently published the book 150 Years of ObamaCare, which details his experiences forming one of the multi-organization working groups that helped lawmakers craft the legislation.

Here's what he had to share:

1. Physician benefits. Although many physicians worry about the impact of increased regulations and penalties under the ACA, Mr. Dawes believes the available incentives can offset this worry.

"There are carrots and sticks for you to leverage, if you understand them," he says. "If you understand what the law entails, where the opportunities are coming from and where the opportunities lie, you should be very well on your way to creating a system that can thrive and succeed."

Mr. Dawes also argues that, on a larger scale, the push from fee-for-service to value-based care will improve the healthcare industry. "Providers are now reimbursed for how healthy they keep their community," he says. "It aligns incentives so that providers are rewarded for building trust with their communities."

2. National insured rate. More than 20 million people are insured under the ACA, and the national uninsured rate has dropped to 8.6 percent, according to Mr. Dawes.

"When you look back over the past 50 years, this uninsured rate is the lowest we have seen in the United States of America," he says. "In 2008, when President Obama was running for office, the uninsured rate was at 16 percent, which was the highest uninsured rate in decades. When you hear today that the uninsured rate is 8.6 percent, that is amazing.

"We want people to understand what is truly at stake," he continues. "It's not as simple as repealing it and starting from scratch — that's what we have to lose."

3. Inclusive coverage. Many know that the ACA mandates coverage for citizens regardless of preexisting conditions, but Mr. Dawes highlights that the legislation also ensures coverage for a variety of minority groups — including those with mental illnesses and those with substance abuse issues.

"Obamacare is the greatest expansion of healthcare coverage in the United States," he says. "This law is also the most comprehensive minority health bill ever created in the history of Congress, with 62 provisions that address minority health and health disparities."

Mr. Dawes credits the ACA's focus on inclusion to the diversity of his working group, along with the diversity of other caucuses that participated in crafting the legislation. "I would argue there is no more inclusive law that has ever been created by the U.S. Congress than our Affordable Care Act," he says.

4. Potential bipartisan support. Although the ACA has proved divisive since its inception, Mr. Dawes asserts that many of the legislation's individual provisions have bipartisan support.

In particular, he notes that the Medicare Access and CHIP Reauthorization Act of 2015, which was a bipartisan federal legislation, expanded many of the ACA's provisions, in terms of healthcare delivery, health equity and payment system requirements.

"The backlash has mainly been on the health insurance reforms," he says. "Even now, you'll hear Trump surrogates, and even Trump himself, say they are going to keep the more popular provisions, like the preexisting condition exclusion provision and dependent coverage up to the age of 26.

"Of course, there are still some issues we have to deal with," he continues, noting his desire to see additional equity provisions related to mental health and social determinants of health added to the legislation. "But we are close to achieving universal health coverage."

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