The Affordable Care Act (ACA), signature legislation of President Obama, was arguably the most
consequential and comprehensive health care reform since Medicare was introduced as part of
President Lyndon B. Johnson’s great society. It has been claimed that many of the law’s reforms are
now so integrated in the health system that full repeal would be impractical, while others including
President Elect Trump have rejected that idea and called for full repeal and replacement claiming
ACA law cannot be fixed. A tsunami of increasing regulatory burden over the past 8 years, the
current health care milieu has moved independent practitioners towards hospital employment
in great numbers. In addition, public opinion has been slowly climbing against ObamaCare with
54% of Americans now opposing the law.
President Obama has indicated that the law has accomplished many of its goals, including
increasing accessibility, affordability, and quality of health care. However, others have contradicted
these assertions and described the ACA as “insurance for many with coverage for few.” Some
believe that the ACA might be more appropriately labeled the “Medicaid Expansion Act.”
There are multiple plans developed over the years by republican members of the congress;
however, of significant consequence and importance are President-elect Trump’s proposals and
the plan developed by Speaker Paul Ryan to repeal and replace the ACA. The President-elect
has described the problems he perceives with the ACA; rapidly rising premiums and deductibles,
narrow networks, and limits of coverage imposed by health insurance companies. The Presidentelect has indicated that his goal will be to create a patient-centered health care system that
promotes choice, quality, and affordability with health insurance and health care, and take any
needed action to alleviate the burdens imposed on American families and businesses by law.
Key words: Affordable Care Act, ObamaCare, Medicaid, exchanges, Trump plan, repeal, replace
Narrow Networks on the Health Insurance Exchanges: What Do They Look Like and How Do They Affect Pricing? A Case Study of Texas
