Date of Award

Fall 12-16-2016

Degree Type

Honors Thesis



First Advisor

Linda Thunstrom


In this paper I examine the outcome of the Affordable Care Act as it pertains to increases in insurance coverage. As part of this, I use prior projections provided before the law took effect by the nonpartisan Congressional Budget Office as a benchmark to determine whether the law met expected growth in insurance rates. The ACA was enacted to make many changes to the U.S. healthcare structure, including the adoption of insurance marketplaces and a cost-sharing system, the expansion of Medicaid, imposing both employer and individual mandates, and consumer protective rules. After examining data gathered by multiple nonpartisan studies, I find that the ACA did not meet expected increases in insurance rates by a range of six to 1.45 percent, and 11.066 million to 12.4 million, respectively. I argue that political polarization as a result of political upset over the law, technical difficulties when opening the Federal exchange, the delay of the individual mandate due to objection over existing policies and related issues, and the delay of the employer mandate resulting from confusion over this portion of the law’s complexity were all contributing factors that affected the law’s inability to provide the increase in coverage that was expected. Additionally, I examine the proposed changes to the healthcare system provided by both Hillary Clinton and Donald Trump, and find that both policies are faced with issues of their own. I conclude that the ACA has provided a valuable model whose strengths and weaknesses may be used to better shape the healthcare structure in coming years.

Included in

Insurance Commons