Single-Payer Health Insurance – Was Obamacare Supposed to Lead to Single-Payer Health Insurance?

Single-Payer Health Insurance – Was Obamacare Supposed to Lead to Single-Payer Health Insurance?

Was the affordable care act supposed to lead to singlepayer

The Affordable Care Act, more commonly known by its acronym Obamacare, makes it illegal for insurance companies to discriminate against people with preexisting conditions and prevents them from setting annual or lifetime coverage caps.

It allows young adults to remain on their parents’ plan until age 26 and provides consumers with more freedom in choosing their doctor and choosing an insurance plan that covers essential benefits.


Though imperfect, the Affordable Care Act (ACA) has significantly decreased the number of Americans without health coverage and cut back on overutilization and uncompensated care costs. Furthermore, discrimination against people with preexisting conditions in private insurance markets has also been eliminated through its provisions.

The Affordable Care Act should serve as a basis for further reforms that increase efficiency and equity in health care delivery. Single payer would help eliminate conflicts of interest by replacing private insurers with one entity that pays providers directly – thus cutting agency costs that contribute to wasteful health care expenditure, making shopping for services that meet your needs much simpler, as well as network rules and benefits mazes that often obscure them.

But waiting for incremental gains under the Affordable Care Act to gain health coverage would leave millions behind, which is unacceptable. Now is the time to move toward universal coverage – and one way is a public option built within existing ACA marketplaces.


Studies suggest a single-payer healthcare system would offer universal coverage without out-of-pocket expenses like copayments or deductibles, saving money through better management and streamlining processes, according to studies. While “single payer” generally implies socialized medicine, countries can achieve universal healthcare coverage even without fully adopting one: for instance, an ObamaCare country may include private options into its design so people with existing private plans could maintain them while simultaneously benefitting from government health insurance plans like Medicare for All (Medicare for all).

The Affordable Care Act has made great strides toward universal health coverage, yet 30 million Americans remain without coverage. Now is the time to move beyond incremental gains and implement a single-payer system to eliminate needless suffering caused by high health costs, disparate care delivery models and uncompensated hospital costs.

Biden’s plan to establish a government-run public option within Obamacare insurance markets and make other improvements has stalled in Congress as attention focuses on dealing with coronavirus pandemic. But his efforts in pushing reform forward should not be overlooked.

What’s the solution?

A single-payer system would reduce the amount spent on uncompensated care for the poor by guaranteeing coverage to all Americans, creating savings that could be used to address other forms of disparate health outcomes that fall outside the scope of insurance policies.

A national public option would provide competition in individual and small-group markets, leading to lower premiums overall. ACP has long advocated for such an initiative as part of a universal health system.

But incremental approaches will not get us there. Our nation can no longer afford to continue spending more on healthcare than other wealthy nations while trailing behind on equity, access, efficiency and care delivery; nor can it bear that people who opt out face higher costs than those who purchase insurance policies. Thus, now is the time for bold action to be taken.

Who’s going to pay for it?

The Affordable Care Act has dramatically expanded access to coverage by increasing the number of people insured, and has increased efficiency and quality by mandating that insurance companies provide value for premium dollars – such as by spending at least 80 percent on medical care rather than advertising or executive bonuses.

Additionally, the Affordable Care Act has increased transparency and accountability by mandating that insurance companies disclose costs, profit margins and service levels to their customers. Furthermore, it has promoted long-term changes to healthcare organization by creating Accountable Care Organizations and medical home initiatives which bring physicians and hospitals together in an effort to promote savings while still offering high quality care.

Although the Affordable Care Act (ACA) has achieved many successes, it has failed to address some of the larger problems facing healthcare. With the Covid pandemic surfacing new priorities such as racial equity in health and rebuilding a fractured public health system. Unfortunately, political gridlock impedes these new initiatives from becoming reality quickly enough.

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About the Author: Raymond Donovan