Strengthen, don’t scrap, the ACA

Fixing, improving, and expanding the law is best approach

MASSACHUSETTS IS A LEADER in health care and caring for our most vulnerable citizens. But even as we drive groundbreaking research and unprecedented care, nonstop efforts to undermine our health care system threaten every one of us and heighten our anxieties.

Our health care system served as the foundation for the Affordable Care Act. Since 2006, Massachusetts’ innovative reform models have focused a system towards patient-oriented care. Now, Massachusetts leads the nation in access to health care, as we have the smallest percentage of uninsured residents of any state. Yet all of our efforts are now threatened as the Trump administration slowly and steadily attempts to dismantle the Affordable Care Act.

For the Trump administration, and others, “fixing” health care means starting over—to try something new. But health care innovation doesn’t have to mean overhaul. The best path to guarantee even better and more affordable care is fixing, improving, and expanding the existing system that we fought for years to obtain and one that we are defending every day from those who wish to dismantle it. In fact, dedicating our time and energy to improving the Affordable Care Act is the only way to address immediate concerns facing Americans, such as lower costs and better quality care. We know this improvement is possible because we did it in Massachusetts. We need to do it again.

Our culture of innovation and consistent, steady progress has not gone unnoticed. That’s why a new Amazon–Berkshire Hathaway–JPMorgan Chase partnership chose Boston to launch a new health care venture to provide healthcare to the more than 1 million individuals who receive healthcare from these three firms. This initiative, headed by Dr. Atul Gawande, has three priorities: better outcomes, better satisfaction, and better costs. And there is perhaps no one more qualified to address why our current system is crucial to achieving these priorities than Dr. Gawande. The alliance of companies says that their goal is to “operate as an independent entity that is free from profit-making incentives and constraints.” Their intentions naturally have been received with some broad skepticism, as large corporations continue to gobble up market share across multiple industries.

It remains to be seen how successful this venture will be or how it might impact the broader healthcare system. However, it’s safe to say that a healthcare efficiency gap exists, consumers and businesses alike are frustrated, and these big three are trying to fill that void.

“Grand plans admit no possibility of mistakes or failures, or the chance to learn from them,” Dr. Gawande wrote. “If we get things wrong, people will die. This doesn’t mean that ambitious reform is beyond us. But we have to start with what we have.”

And what we have today is a success story. Millions more Americans now have access to coverage thanks to the Affordable Care Act. At the same time, we should celebrate ACA’s remarkable gains, while also acknowledging where it came up short. In Massachusetts alone, the cost of surgery in one hospital can cost $10,000 more than the same procedure in a different hospital. This is the case across the country.

That ACA can and should be better means that we should strengthen it rather than scrapping it. We can innovate and improve. We can eliminate barriers to care, provide more options, and lower costs. But we can only succeed in this endeavor by coming together.

Meet the Author

Andy Vargas

State Representative, Massachusetts Legislature
Meet the Author

Stephen Kerrigan

Former candidate, Lieutenant governor
We hope that you join us in calling on our current and future elected officials and policymakers to use innovation to improve our health care system, not end it. That is the one way to guarantee better care, better prices, and better access for all.

Andy Vargas represents the 3rd Essex District in the Massachusetts House of Representatives; Steve Kerrigan is the former Democratic nominee for Lieutenant Governor