Submit a paper (1,250-1,500 words) focusing on public health reform. Provide an overview of the current status of public health in the United States. Review a portion of the Affordable Care Act and present the strengths and weaknesses of the plan, as well as make suggestions for plan improvement. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Title: Public Health Reform in the United States: Assessing the Affordable Care Act


Public health reform plays a critical role in improving the health and well-being of populations. In the United States, the public health landscape has seen significant changes in recent years, especially with the implementation of the Affordable Care Act (ACA) in 2010. This paper provides an overview of the current status of public health in the United States and focuses on analyzing a portion of the ACA. The strengths and weaknesses of the ACA will be presented, along with suggestions for its improvement.

Overview of Public Health in the United States:

Public health in the United States is a multifaceted field that encompasses efforts to prevent disease, promote health, and prolong life for entire populations. It is primarily governed at the federal level by agencies such as the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) and implemented through state and local health departments. Public health activities include disease surveillance, health education, vaccination programs, and environmental health monitoring, among others.

Despite advancements in medical technology and healthcare delivery, the United States faces several challenges in public health. These challenges include health disparities, rising healthcare costs, an aging population, and the increasing burden of chronic diseases. Additionally, the COVID-19 pandemic has highlighted the vulnerabilities in the U.S. public health system, such as limited funding, inadequate infrastructure, and fragmented coordination among agencies.

An Analysis of the Affordable Care Act:

The Affordable Care Act, also known as Obamacare, was signed into law in 2010 to address some of the shortcomings in the U.S. healthcare system and improve access to affordable healthcare services. The ACA introduced several reforms, including the expansion of Medicaid, the creation of health insurance marketplaces, and the prohibition of discriminatory practices by insurance companies based on pre-existing conditions.

Strengths of the ACA:

The ACA has made notable contributions to public health in the United States. One of its primary strengths is the expansion of health insurance coverage. According to the U.S. Census Bureau, the uninsured rate among Americans dropped from 16.3% in 2010 to 8.8% in 2017, resulting in millions of previously uninsured individuals gaining access to essential healthcare services.

Furthermore, the ACA has improved preventive care by requiring insurance plans to cover a range of preventive services, such as vaccinations, screenings, and counseling, without cost-sharing. This emphasis on prevention can lead to better health outcomes and lower healthcare costs in the long term.

Another significant strength of the ACA is the inclusion of essential health benefits (EHBs). Insurance plans offered on the health insurance marketplaces are required to cover ten EHBs, including hospitalization, prescription drugs, mental health and substance abuse services, and maternity care. This comprehensive coverage ensures that individuals have access to a broad range of necessary healthcare services.

Weaknesses of the ACA:

Despite its achievements, the ACA also has certain weaknesses that hinder its effectiveness in achieving comprehensive healthcare reform. One of the main weaknesses is the affordability of health insurance premiums for many individuals and families. While subsidies are provided to help lower-income individuals afford coverage, the premiums for some middle-class individuals can still be prohibitively expensive.

Additionally, the ACA’s individual mandate, which required individuals to have health insurance or pay a penalty, was repealed in 2017. The elimination of this mandate has led to concerns about the stability of the insurance market and the potential for adverse selection, where healthier individuals choose not to purchase insurance, resulting in higher premiums for those who remain insured.

Improvements to the ACA:

To improve the ACA and enhance public health outcomes, several areas warrant attention. First, efforts should be made to address the affordability of health insurance premiums, particularly for middle-income earners who do not qualify for subsidies. This could be accomplished through the expansion of subsidies or the implementation of innovative strategies to reduce healthcare costs.

Second, the ACA could benefit from increased investment in public health infrastructure and prevention-oriented programs. Allocating resources to improve disease surveillance systems, expand vaccination programs, and promote healthy behaviors can help reduce the burden of chronic diseases and mitigate future public health crises.

Finally, policymakers should consider reinstating some form of an individual mandate or implementing other mechanisms to encourage broad participation in the insurance market. This would help stabilize premiums and ensure that healthier individuals are not opting out of coverage, thus maintaining a balanced risk pool.


Overall, the ACA has had significant impacts on public health in the United States, particularly in terms of expanding insurance coverage and improving preventive care. However, challenges remain, including affordability issues and the need for further investment in public health infrastructure. By addressing these weaknesses and implementing suggested improvements, public health reform in the United States can continue to progress and positively impact the health and well-being of the population.

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