At the White House: Reflecting on five years of the Affordable Care Act

Recently, I had the opportunity to attend an event at the White House marking the fifth anniversary of the Affordable Care Act and kicking off an initiative that focuses on paying health care providers for quality instead of quantity.

The “Better Care” initiative, in part, involves forming an advisory group called the Healthcare Payment Learning and Action Network, which will serve as a forum to identify, share and advise on best practices that will help the country shift to value-based and alternative payment models.

Providence is proud to participate as a member of this network because it aligns with our commitment to innovative models, such as our accountable care organizations with Boeing and Intel. It’s also a chance to learn from others and be a voice for accelerating change on a large scale. Payment models that promote healthier communities are one of the key levers for fixing the U.S. health care system. As the president put it:

“We don’t want incentives to be skewed so providers feel obligated to do more tests. We want them to do the right tests. We want them to invest money on the front end to prevent disease and not just on the back end to treat disease.”

Health care is a right, not a privilege

Being at the White House on the anniversary of the ACA was also an opportunity to reflect on how far we’ve come in just a few years. Though the law is far from perfect, it marked a fundamental turning point for our country: It was the first time the United States formally declared health care as a right, not a privilege, which is something Providence has always believed.

Anne Ha, center, gained coverage through the Affordable Care Act. Having later been diagnosed with cancer, she says the ACA saved her life. Anne was invited to the White House to commemorate the fifth anniversary of the ACA.

Today, 16 million more Americans now have access to care. Insurers can no longer charge more or deny coverage to people with pre-existing conditions. Preventive care is now fully covered. Lifetime limits on care have gone away, and young people can now stay on their parents plans until age 26.

Though the nation still has a long way to go on the journey, it’s important to pause and take stock in what we’ve accomplished so far. Milestones like the fifth anniversary give us a chance to renew our commitment, so that we can keep the momentum going and step up to meet the challenges ahead. With all the varied parts of the U.S. health system working together, we can make the large-scale change needed to create healthier communities across the country and ensure every person in America has access to high quality, affordable health care.

21 Comments
  1. Here’s what the ACA did for me: Cancelled a perfectly good health care plan that I had for eight years because it didn’t provide something I don’t need. Made my General Manager waste hundreds of hours trying to interpret the rules, work with consultants, brokers, and adviser to try to figure out how the law even works. We now have a health plan that is so much more costly that i have to have my employees subsidize the cost. Higher deductibles accompany those higher premiums as to arguments with the ‘medical director’ who questions prescribed treatment (my PCP had to literally challenge is credentials when he rejected the request for an MRI. I needed knee surgery). I am no longer free to just go to a specialist; i must see my PCP, even though he cannot treat me. The ACA is a good intention executed really badly because of two fundamental flaws: A) You cannot legislate for 15% of the population and expect the other 85% to ‘fit in’. B) It failed to remove the ‘for profit’ motive for the insurance companies. The result it that the medical community and all patients are now beholden to reimbursement plans instead of actual medical care. A doctor working for a big hospital or insurance-owned medical practice who doesn’t see XX patients a day will not be reimbursed. And the reimbursements are shrinking so who would want to be in that industry any more anyway. The ACA didn’t cause this, but is sure accelerated it. Repeal and re-write. Oh, wait Congress…..never mind, they would have to actually DO something.

    • First you state that you lost your plan due to the ACA, and then reference to the fact that your General Manager had to deal with trying to figure out all the changes. Does your General Manager own the company you work for? The only people who had to review the changes were the insurance companies and since those insurance companies were consulted when the law was written…your post makes no sense. My company didn’t lay anyone off, in fact, they have hired more people. My copay for doctor visits only went up $10 dollars to $35 dollars and that was the only change. I was able to put my Daughter back on my coverage. My previous policy had a $2 million dollar lifetime limit…now there is no limit.

      Where are all the layoffs and people losing their company insurance plans that the PUBs said would happen. That’s why we don’t hear anything about those PUB talking points anymore. All the lawsuits brought against the ACA have been sponsored by the PUB hierarchy including the one before the supreme court now. This current one, if the PUB controlled court rules in its favor will knock 6.7 million people off of plans. I guess the PUBs wouldn’t mind that just so they could finally put a dent in the law. Mind you that only 4 PUB states decided to implement state exchanges. All DEM states did!!!

  2. I am grateful & feel privileged to have had the opportunity to choose a career that has always afforded me the luxury of healthcare insurance coverage. I have also always felt that the insurance companies’ bottom-line drives the care we provide.
    For the first 15 yrs of my career I worked in Emergency Departments from So. Calif. to Northern Washington. The E.D. is where those who are not fortunate enough, or cannot afford coverage, or even basic healthcare, come in desperation. They come when they can no longer hold out & usually are much sicker, sometimes irreversibly, because of lack of that basic care that some of us take for granted. I am proud to work for Providence. It is truly the best organization I have ever worked for. Thank you God, that this country has finally chosen to start defining healthcare as a right not to be reserved for a privileged few.
    Jennifer Peery

  3. I am grateful & feel privileged to have had the opportunity to choose a career that has always afforded me the luxury of healthcare insurance coverage. I have also always felt that the insurance companies’ bottom-line drives the care we provide.
    For the first 15 yrs of my career I worked in Emergency Departments from So. Calif. to Northern Washington. The E.D. is where those who are not fortunate enough, or cannot afford coverage, or even basic healthcare, come in desperation. They come when they can no longer hold out & usually are much sicker, sometimes irreversibly, because of lack of that basic care that some of us take for granted. I am proud to work for Providence. It is truly the best organization I have ever worked for. Thank you God, that this country has finally chosen to start defining healthcare as a right not to be reserved for a privileged few.

  4. What the “Affordable Care Act” did for my family is take away medications that were effective and had him go to a medication with known negative side effects, that does not work as well as the one he had taken for 3 years, prior to this law.
    Almost imposssible to get a medical provider to take a new patient that has this type of coverage in Washington. Clinic posting that if you loose your benefit for ANY reasaon ( even human clerical ones) you will have to find a new provider.

    I am thanksful for the care we have at Providence but it does cost out of pocket vastly more then workers at Kaiser.

    Pauline

  5. I completely agree with John.

  6. The Affordable Care Act sounds like a good idea, but has some terrible loopholes for hard working people. If both you and your spouse lose your job & health insurance and made too much money the previous year or are eligible for COBRA at $2200/mo, you do not qualify for any of the reduced rates. Under the cheapest plan, you can still be liable for approximately $20,0000 or more per year in health costs. Bottom line is that you either get penalized on your taxes or pay at least $900/mo and not seek health care….ever, if you can help it. There are already very few resources available for the “middle class” tax payers that fall on hard times, adding a penalty for losing health insurance doesn’t help.

  7. 16 million Americans having health coverage who did hot have coverage before the ACA is a blessing to be thankful for, and a contribution to the well-being and health of the United States of America. Thank you for your leadership Dr. Hockman; I’m sure the founding Sisters of Providence would consider you a wise man.

    Vanessa Salinas

    • How can you give credit to Rod Hochman for doing nothing, other than making millions of dollars a year and taking credit for something he had nothing to do with. It clear that you are out of touch with the reality of the ACA law. It does nothing but fundamentally change who pays a majority of the medical bill.

      We dont need an insurance company running healthcare and making decisions for me. I am paying $1,500 deducatble, then I have to pay $3,500 out of pocket expenses, before my insurance pays the 100% that I pay more in monthy premiums for. The only thing the ACA does is give cart blanche to the insurance companies that will continue to raise the cost of healthcare and pocket more and more money.

      We need universal healthcare not healthcare where more of the costs are being shifted. Healthcare is NOT a business, if its a fundamental right then that in and of itself takes it out of the business sector. Rod Hochman is no wise man, not gift to healthcare, he is a doctor turned administrator for the sole benefit of making himself millions of dollars a year. We need a healthcare system modeled after the Europeans Healthcare system.

      And no, people are NOT dying waiting for care, that is the propaganda and koolaid we are forced to drink. I lived in Europe for many years and no one died waiting for anything. I broke my hand adn was seen the same day, had surgery the same day, had follow up care physical therapy etc. The upside is, I never received a bill never.

      I came back to the US and was in an auto accident sustained many serious life threatning injuires, ther person who casued it had nothing. I got stuck with $400,000 dollars in medical bills. Lost everything I had worked for my house, my car, my State job, my ability to walk for two years. I am still currently being sued again because I dont have $60,000 just laying around. Thats our medical system, people buy and sell healthcare stocks, making even more money on someone elses misery, thats your wonderful ACA, pull your head out of the sand and look around at what is really happening to out healthcare system. the only people dying for lack of medical care are the poor, and elderly.

      Rod Hochman is no saint, he hasn’t worked fop Providence for very long, and I highly doubt the sister would be proud of him. I dont think thier vision was to create a multibillion dollar business out of the misery of others.

      • This is a good time to remind everyone of our commenting policy, which is based on our core values of respect and compassion toward one another. We encourage dialogue and know that everyone won’t always agree. But let’s keep it respectful and no personal attacks. Thank you. -Melissa Tizon, senior communication director

      • John, your comments judging Dr. Hochman are disrespectful. You have some valid points about the state of healthcare in general, but attacking him personally is entirely out of place, if not nonsensical (‘doing nothing’).

        Whether Dr. Hochman is a saint or not is not our place to judge. I’m no saint either, but I have to say he does quite a bit, and he does his best to encourage us and share what he’s doing in a blog, and making himself vulnerable in doing so.

  8. Isn’t health care what we do to take care of ourselves? Living according to design, referring the ‘Manufacturer’s’ Guide?

    How much of what we call ‘health care’ costs(I see it as health crisis intervention) are due to poor lifestyle habits?

    While thankful for the crisis care that is provided, I’m concerned that we insist on a ‘right’ to ‘health care’ without insisting, with equal or greater energy, on exercising our responsibilities to be good stewards of our spirits, souls, minds and bodies, the others around us, and the earth below us. Our choices can be very costly to others.

    Thank you for your leadership and communication, Dr. Hochman.

  9. Dr. Hochman,

    I am beyond grateful to work for an organization that was founded by the love & altruistic Sisters of Providence and continues to operate under their Mission & Core Values. My heart & spirit smiled when I read your statement, “Though the law is far from perfect, it marked a fundamental turning point for our country: It was the first time the United States formally declared health care as a right, not a privilege.” I have already repeated that quote several times (giving you credit, of course – smile). It is a privilege to serve the poor & vulnerable and I thank you for your leadership.

    • Thank you for the note, Charie, and for all you do for Providence. I am grateful to be part of this organization as well.

  10. Good morning Dr Hochman,

    This step into further government dependence will no doubt help save the lives of our less fortunate citizens by allowing them access to healthcare and no doubt save many lives. The question is this: How is this different from before times? Charity healthcare has been around since before the creation of our country and will continue. The question in my mind is: What will be the cost to American freedom? Sure, this is another brick in a long line of fundamental shifts away from our roots but it is a major brick and, as you stated, a turning point. Ultimately, I believe we will see the error of our ways, but it might be too late.
    The beauty of America is we are free. Free to choose success or failure and we get this choice presented to us everyday. However, when we become too lazy as a society to take responsibility for our own welfare, there is a cost to pay. The the price for freedom is something that I’m prepared to pay and I will raise my children with this mindset.
    Have a great day everyone and remember, we are free to succeed or fail, it’s our daily attitude and trust in God that makes the difference.

    • Are you really calling people lazy? Do you know that most people on welfare do work? They just don’t earn a high-enough wage to live off of. That’s the crux of the problem, not laziness. The last time I checked calling people lazy was not very nice. Hopefully your trust in God will show you that someday.

      • @Matt- I don’t believe Daniel was referring to people who need welfare/public support; I believe he was referring to those who are “lazy” in making good choices to care for themselves- i.e. poor lifestyle habits, their own physical welfare.

        @Daniel- When you refer to people who have chronic illnesses that can be related to lifestyle, please don’t assume that it’s because they are lazy. What we know about health and nutrition is constantly evolving. I grew up being taught that my diet was good as long as I stayed away from cholesterol (so sugar wasn’t a big deal), AIDS happened to homosexuals, and people who are depressed just need to get a grip. Childhood habits become deeply ingrained, and once you’re down the wrong path it can be difficult to turn around- sometimes your very body resists, doing what it is designed to do in historically different circumstances (think nicotine addiction and metabolic syndrome). Yes, there is still a cost to pay for a lifetime of unhealthy habits, but realize that most people don’t choose to be in that situation once they’ve learned how they got there. Have compassion- provide support to those who want to change.

      • Matt, we Americans have given up our personal responsibility to caring for ourselves and our loved ones at what cost? Our freedoms. I’ll elect somebody to give me what I want, irregardless of the cost it may incur for others and other generations. This is laziness in my oppinion and so we find our society in decline overall, in general. Freedom costs something called personal responsibility. Our current culture, as a whole, stands there asking what will the government do for me today without understanding what it will cost us? Nothing is free, especially from the government. I think it’s based in envy and laziness but not sure completely. The greatest gift from God is the ability to choose. We can look to man (fallen man) for some things that we need or we can look to God who has everything we need. No doubt the achievements in healthcare have been tremendous and we need that, but the means is up to us. The principal of supply and demand, this is the driver of our American economy. I can only imagine how many trillions of dollars that have been raised and spent on cancer research for instance. High demand has led to high prices because cancer is such a dreaded disease. But I must ask – What incentive does pharma have in actually finding cures? I know I sound like a scruge to some, but has anyone ever asked the question? What kind of return have we had on our investment? I know that would sound uncaring to most of our society, but reality speaks loudly. I’m not saying there aren’t things that we rely on from our fellow man, I an simply addressing an attitude that seems to saturate our culture. We sometimes blindly just funnel money to these efforts and how is it being spent? We funnel money to our government, and how is it being spent? Accountability on a personal level is missing and, therefore, missing from our institutions. This is to our detriment and puts an ax to the tree of freedom. Thank you

    • In 2008 a good friend of mine was diagnosed with a rare and aggressive form of cancer. After radiation, chemo, surgery and another round of chemo she survived and thankfully is still cancer free. At the time their medical coverage, which they considered to be good, saved them from bankruptcy. Still, their portion of the medical bills entirely depleted their retirement accounts. With the advent of the ACA they were able to reduce their monthly insurance premium from over a $1000 to around $350 with better coverage. They are industrious people, not lazy, who feel incredibly fortunate to have the ACA as a safety net in their mid-sixties so they can try to salvage their retirements.

  11. when someone gets something for a reduced rate then others must cover the cost.
    Personally my insurance is up to 900.00 per month now that the we are paying for Oboma care, and no I don’t have much money.
    When I retired I payed zero dollars a month but when the new laws went in I was forced into a different plain.
    Not everyone thinks this new insurance is great.

  12. Thanks Dr. Hochman for the update.

    Looking forward to the next 5 years in Affordable Care Act.

    Cheers

    Henry PAN