The ACA subsidy cliff is coming. Millions will lose coverage or face crushing premium hikes.

And yes, that’s a massive tragedy for patients, including many that I know.

However, it’s also a reflection of the tragic flaw in the ACA’s design itself.

Every time we celebrate an “affordability” initiative in healthcare, we should ask: Affordable to whom?

When the ACA subsidizes premiums, the patient still pays…through taxes.

When employers absorb rising costs, employees still pay through higher premiums, stagnant wages, and reduced benefits.

When pharmaceutical companies launch “patient assistance programs,” we still pay, through higher prices elsewhere in the system.

We’re not reducing costs. We’re playing an elaborate shell game with who writes the check.

The ACA didn’t fix healthcare. It papered over a broken system with subsidies that require constant expansion to maintain the illusion of affordability—a stopgap. Not a solution.

Now the paper is peeling back.

And we’re about to see what we’ve actually been paying private insurers for coverage that still leaves many families one diagnosis away from bankruptcy.

Real affordability isn’t about shifting who pays.

It’s about spending less while delivering more.

That’s the conversation we’ve been avoiding for 15 years.


—-
Bhargav Raman, MD, MBA, is the cofounder of Ten Ten Ten, a nonprofit dedicated to fixing our broken system.

Want real lasting change? Sign the Pledge at https://lnkd.in/gYkWd-8s

#HealthcareReform #TenTenTen #ObamaCare #ACA #AffordableCareAct #Affordability

Originally published by Bhargav Raman, MD
Cofounder, Clinical Strategy and Analytics
https://www.linkedin.com/posts/universalistmd_healthcarereform-tententen-obamacare-activity-7408885281908723712-eVAG