Healthcare Reform Law (Obamacare): Update on “The Good, the Bad, and the Ugly” and the Persistence of Polarization on Repeal and Replace

In my 2011 book, Healthcare Disparities at the Crossroads with Healthcare Reform, I detailed the Patient Protection and Affordable Care Act, or the ACA, also often referred to as Obamacare, and spoke of it as having good, bad, and frankly ugly characteristics, so regarded according to one’s political orientation. Under the “good” aspect, Obamacare might be considered as a blessing that uplifts the health and welfare of mankind and accomplishes the “Triple Aim” of healthcare reform: (a) provision of greater access to healthcare for the American people; (b) lowering the costs of medical treatment; and (c) increasing the quality of healthcare delivery. Under the “bad” rubric, it may be thought of as a well-intended piece of legislation that is incomplete in that it does not provide universal coverage of the American population. Under the “ugly” title, it might be seen by its Republican detractors as a downright danger to the public in not providing the promised high standard of healthcare and in being too expensive. In this chapter, we will examine the progress made in reforming healthcare delivery in the United States, and we will briefly consider the pros and cons of Obamacare and the attempts that are being made to repeal, replace, augment, change, and improve it.