The End Of The ACA Mandate And The Beginning Of Healthcare Consumerism

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The End Of The ACA Mandate And The Beginning Of Healthcare Consumerism

The passage of the Republican tax reform bill with the removal of the mandate is a win for the American patient and doctor.

Since the passage of the Affordable Care Act there has been a steady unraveling of the American healthcare system. There has been a loss of access to healthcare for those who live in rural areas and those who are underserved in cities; the middle and working class have been priced out by high insurance premiums and the exponential rise in out of pocket costs; there has been a devastating loss of independent physicians (now accounting for only 30% of practicing physicians); and has been a steady rise in the consolidation of corporate hospital systems and medical insurance companies. Each change has caused a decrease in choice with a resultant rise in cost leading to the all too familiar ‘too big to fail’ phenomenon.

The removal of the mandate allows those who cannot afford to purchase a product or those who have purchased a product that they don’t need or want to be free to find healthcare coverage that will work for them.

The best part about the law is a change in a direction that respects the individual. If you like the ACA you can keep it, but if you don’t like it you will no longer be penalized. This one change will allow consumer driven healthcare to thrive and encourage the market create products that will benefit the patient.

The argument that the ACA has increased access has been disingenuous. After the passage it became obvious that the promises made were never going to be kept.

  • If you like your doctor you could keep your doctor

This did not happen. There was a very large number of independent doctors who opted out of the ACA plans, sold their practices or left the practice of medicine because of dissatisfaction with the direction of healthcare. Patients who bought plans on the exchange quickly found out that they had access to a very small physician network.

  •  Patients will have access to quality healthcare

Top tier hospitals limited the number of ACA plans that they accepted

  • · Patients will have access to affordable healthcare

Many patients found that they were paying higher premiums (for example over 100% increase in Arizona) with little or no choice because insurance companies fled the market.

  • Patients will lose healthcare coverage without the ACA

The argument that removal of the mandate will mean that people will lose healthcare does not take into account those who were paying the fine because it was cheaper than maintaining coverage.

Potential Benefits 

Healthcare has become big business and patients will be encouraged to become healthcare consumers. Imagine the new direction that can be taken:

  •  Insurance companies will begin to offer products that patients want such as low cost catastrophic plans that offer only what the patient wants instead of high cost cafeteria plans with coverage that they don’t need.


  •  Growth of  medical care with transparent pricing offered by direct primary care practices and specialists which have a flat membership fee will will continue expand.


  •  Medical cost sharing companies such as Liberty HealthShare that take advantage of the lower price structure of self pay rates offered by labs, doctors offices, hospitals and prescription medication will thrive.


  •  Using supplemental policies such as AFLAC which offer affordable major medical coverage for cancer, surgery, hospitalization and other big ticket medical services and care will become a routine option that can be added to those with medical insurance plans and as a stand-alone policy for those without medical insurance.

This law provides a real fix for our health care system encouraging choice instead of a one size fits all approach. In short, it will lead to the new frontier of healthcare consumerism that will offer something for everyone.

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  1. […] by Dr. Elaina George […]

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