More than 30 healthcare laws signed by Gov. Whitmer from last term are set to take effect on or after April 1. Some of these laws include state level Affordable Care Act codifications, increased …
The MHA was recently awarded $2.5 million to expand access to hospital-based peer recovery coach services. The funding was appropriated by the Michigan Legislature as part of the state fiscal year 2025 budget to …
The Michigan Department of Health and Human Services (MDHHS) Maternal Mortality Surveillance Program is seeking professionals and community members to join the Maternal Mortality Review Committee (MMRC) and Recommendations Workgroup. These committees play a …
U.S. Secretary of Health and Human Services (HHS) announced March 18 the renewal of the public health emergency (PHE) declaration addressing the ongoing opioid crisis. This extension, which lasts for 90 days, allows continued federal …
The Michigan Department of Health and Human Services (MDHHS) recently launched the Michigan Public Health Dashboard, a tool designed to improve access to key health data and support informed decision-making. This publicly accessible resource assists …
Members of the MHA Person & Family Engagement (PFE) Advisory Council will share how integrating the MHA Roadmap to Person and Family Engagement develops and strengthens PFE efforts in their organizations through two upcoming PFE …
The Institute for Healthcare Improvement Patient Safety Congress brought together voices from across the healthcare spectrum March 9 – 11, uniting leaders, learners and advocates in a shared goal of delivering safer care to …
Keckley Report
The Fundamental Flaw of the Affordable Care Act
Today marks the 15th anniversary of the Patient Protection and Affordable Care Act (ACA). It is the most consequential and controversial health legislation in our country’s history since LBJ’s Social Security Amendments created Medicare and Medicaid in 1965.
When passed March 23, 2010, 41% of adults held a favorable view of the law vs. 44% who were unfavorable. Today, 64% have a favorable view vs. 36% unfavorable (KFF). The 900-page law sought expansion of insurance coverage, reduced health costs and improved quality of care. But its results to date are mixed: coverage increased from 84% to 92% but costs have grown unabated and quality improvements have been significant in some areas and negligible in others.
In retrospect, the ACA is fundamentally flawed because it failed to recognize changes in the healthcare marketplace upon which systemic improvements could be achieved …
The ACA defaulted to a focus on insurance coverage and neglected attention to cost containment and quality improvement. As its implementation unfolded from 2010-2013, insurance coverage drew the lion’s share of attention and political opposition grew. Key amendments i.e. the deletion of mandates (proposed by conservative think-tanks to stabilize risk pools) and the June 2012 Supreme Court decision that delegated Medicaid expansion to states neutered its impact. Would-be systemic reforms became incremental changes comfortable to insiders and non-responsive to outsiders.
The ACA is fundamentally flawed because its Beltway-based collaborators did not accurately assess the environment and assumed incremental improvement to the status quo was enough. They were wrong; the public’s demanding more.
The ACA is an important component in health policy today but its fundamental flaw should be acknowledged.”
Paul Keckley, March 23, 2025
- Registration is open for the highly anticipated MHA Keystone Center Safety & Quality Symposium, scheduled for April 28 and 29, 2025, at the Kellogg Conference Center & Hotel, East Lansing.
- The American Hospital Association (AHA) is accepting applications for the annual 2026 AHA Foster G. McGaw Prize now through May 6, 2025.
Lauren LaPine, senior director, legislative and public policy, MHA, appeared on the MIRS Monday podcast published March 24 to discuss the state behavioral health system. LaPine spoke about the challenges associated with patients boarding in …
Healthcare Laws Set to Take Effect April 2025
HHS Renews Ongoing Opioid Crisis PHE
MHA Members Share Strategies for Advancing Person and Family Engagement
How Policy Shapes the Patient Experience: Reflections from a Public Policy Fellow
The Fundamental Flaw of the Affordable Care Act
News to Know
MHA in the News
MHA Keystone Center Safety & Quality Symposium Approved for CE Credits
Are the 7 Presumptions on which the U.S. Health System is Built still Relevant?
The American Hospital Association (AHA) is accepting applications for the annual 
