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Since 2014, more than 20 million people have received some form of healthcare coverage through the ACA, according to the Center on Budget and Policy Priorities, a left-leaning think tank. The share of Americans who reported not going to a doctor due to cost concerns and skipping a prescription because they couldn’t afford it fell from 2010 to 2018. “Without the ACA we would not have the resources to take care of the patients we get to see every day now,” said Dr. Efrain Talamantes, medical director of the Institute for Health Equity at Los Angeles-based AltaMed. (Johnson, 3/14)

Congress created the Center for Medicare & Medicaid Innovation under the Affordable Care Act to design, test and expand new payment and care delivery models that cut spending without lowering the quality of care or increased quality without raising expenditures. It was also supposed to hit on the third leg of the so-called Triple Aim by improving the overall health of Medicare and Medicaid beneficiaries. (Brady, 3/14)

For all of its success in expanding health coverage to more than 20 million Americans, the Affordable Care Act has stumbled in a key area: affordability.Despite various provisions tucked into the law aimed at lowering costs, consumers continue to face high prices from both providers and insurers. And 10 years later, affordability is at the center of policy debates over healthcare. One of those efforts, the medical loss ratio rule, was touted by the Obama administration as a tool for lowering premiums, but in the long run, it may be having the opposite effect. (Livingston, 3/14)

After a contentious start a decade ago, the Patient-Centered Outcomes Research Institute was able to demonstrate how much perceptions have changed when Congress recently reauthorized its operations for another 10 years with bipartisan backing. The formation of the institute, often called PCORI, was one of the most controversial elements of the Affordable Care Act because of concerns flourishing among Republicans that it would lead to rationing of care. (Castellucci, 3/14)

The trade-off seemed simple in theory—hospitals would need less federal funding when the Affordable Care Act extended coverage to millions of Americans. But 10 years later, the forecast seems a lot more cloudy—obscured by a host of separate but intertwined Medicaid supplemental payments and financing mechanisms. Few are satisfied with the current patchwork of disproportionate-share hospital payments and intergovernmental transfers that stitch together a convoluted state and federal financing system that can divert funding from the hospitals most in need, industry overseers say. (Kacik, 3/14)