WAUWATOSA — Nearly five years since President Barack
Obama signed the Affordable Care Act into law, health
organizations and industries connected to them are
evaluating how the first years have gone and what the
major effects have been.
During a panel discussion Monday at the Medical College
of Wisconsin, Froedtert Health President and CEO Cathy
Jacobson said the ACA has spurred a considerable amount
of experimentation, especially in terms of Medicare and
dealing with reimbursement levels.
“Medicare is so pervasive. It’s the single largest payer
of health care expenditures for any provider in the
United States. Whenever they do something a different
way in terms of reimbursement, that’s when it impacts
the commercial market and that’s what has been going on
for the past five years,” she said.
“Just about every major payer, in fact every major payer
across the United States and most major health care
systems, are involved in commercial arrangements that
are taking on those experiments in some way, shape or
form. So while that may be a consequence of the law, it
is not written into the law, but it has been one of the
biggest changes that we have seen in the last five
When the experiments occur in the commercial market,
Jacobson said there is more opportunity tweaking it and
trying to get it to match the needs of different
communities of people compared to when it’s done by
Medicare and tends to be a more “cookie cutter”
“There has been a lot of experimentation and it truly
has started to change the way that health care providers
are viewing their future,” she said. “I have never seen
the health care system voluntarily moving toward a
different way as much as I have seen in last five
WEA Trust President and CEO Mark Moody said the dire
predictions that came out in advance of the Affordable
Care Act never came to fruition.
“Health care costs have not skyrocketed as some had
predicted. Employers have not abandoned their sponsored
plans in droves as was predicted. Insurance companies
haven’t gone bankrupt,” Moody said.
In fact, Moody said there have been many beneficial
effects, such as 11.7 million people covered under state
and federal exchanges, many of whom would not have had
health insurance otherwise. In addition, Moody said,
there have been millions of young adults who have
obtained health care coverage under their parents’ plans
until the age of 27.
Moody also highlighted that the ACA eliminated the
doughnut hole in Medicare Plan B, which he said was a
relief for many seniors, as well as high-risk insurance
programs being eliminated in Wisconsin.
Confusing to small employers
While insurance companies and larger corporations were
more equipped to deal with the changes, it left small
employers unsettled, Moody said.
“Small employers were really baffled. There was so much
coming at them so quickly and they didn’t have the
resources, the expertise within their own organizations
to cope with that,” he said, adding the Obama
administration did give them a one-year reprieve.
When assessing the ACA, University of
Wisconsin-Milwaukee health care economist Owen Thompson
said the real question is did the law achieve its main
purpose which was to expand health care coverage in the
“The good chunk of it was supposed to come from Medicaid
expansions and I think that has proceeded more or less
as planned,” Thompson said. “Of course the Supreme Court
made it optional for the states and the states, notably
Texas and Florida, in terms of individuals chose not to
Overall, Thompson said health care exchanges are
functioning as they were intended to and health care
premiums have remained fairly consistent.
“As far as the narrow goals of the law go, in my opinion
it’s more or less working OK,” he said.
Thompson added he’d give the ACA a grade of C, according
to what the grade meant in 1980.