The Affordable Care Act (ACA) Stabilization Efforts: The Alexander-Murray Bill

Respond to your colleagues* by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

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The Affordable Care Act (ACA) Stabilization Efforts: The Alexander-Murray Bill

The Alexander-Murray bill, introduced in 2017, wanted to strengthen and stabilize implementation of the Affordable Care Act (ACA). This bipartisan legislation, named for Senators Lamar Alexander and Patty Murray, addressed concerns surrounding stability of individual insurance markets under ACA; cost-sharing reduction payments to insurers were restored; state flexibility in implementing it was expanded (115th Congress, 2017).

Background of the Problem or Issue

The Affordable Care Act was implemented in 2010, in an attempt to expand access to affordable health insurance coverage. Unfortunately, its implementation presented many difficulties, including concerns over market stability (including rising premiums, limited insurer participation and uncertainty surrounding cost-sharing reduction payments) that compromised affordability and availability for individuals and families (Ng Kamstra et al. 2021).

Social Determinant Affecting Policy

Income and socioeconomic status have an immense effect on this policy. The Affordable Care Act's aim was to make affordable coverage more available for low-income individuals and families through subsidies and cost-sharing reduction payments; instability in individual insurance markets has disproportionately harmed those with lower incomes, making it harder for them to access healthcare coverage (States Work to Make Individual Market Health Coverage More Affordability 2020). Thus addressing this issue through stabilization efforts like Alexander-Murray bill would have an enormous effect on this social determinant factor (States Work to Make Individual Market Health Coverage Affordable 2020).

Evidence Base in Support of Proposed Policy

There is ample support for Alexander-Murray bill's proposed policy of stabilizing ACA through cost-sharing reduction payments and market stabilization efforts on health insurance markets and individuals' access to care. Multiple studies and analyses have examined their effect.

Commonwealth Fund report revealed the significance of federal insurance payments for individual market health coverage stability and affordability, including restoration of cost-sharing reduction payments; their study demonstrated how doing so would result in more affordable premiums for lower income individuals, leading to greater enrollment and improved access to care (States Work to Make Individual Market Health Coverage More Affordability 2020).

Also, an analysis published in BMJ Global Health explored the shortcomings of the Affordable Care Act marketplaces in Hawaii and highlighted their need for stabilization efforts to address vulnerabilities among specific populations. Policy interventions must ensure access to affordable coverage; long-term solutions need federal leadership (Ng Kamstra et al. 2021).