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Student 1: In a poll done by the Kaiser Family Foundation, as of 2019, the number one reason for being uninsured in the U.S. is “coverage not affordable” (Tolbert et al., 2020). The Affordable Care Act (ACA) attempted to fill many of the gaps in access and affordability with Medicaid expansion, a marketplace for individuals, small employers, provisions to promote employer-based coverage, and the extension of dependent coverage in the private market.

However, in 2017 the Trump Administration began to attempt to dismantle the ACA, the The administration stopped making payments to insurers for cost-sharing reductions. In addition, in 2019, the individual mandate was repealed; due to these changes, many healthier consumers began to leave the marketplace, leaving a “sicker group,” causing prices to increase in the marketplace (Garfleld et al., 2019). The marketplace also became less regulated, and short-term limited duration (STLD) plans could return to the marketplace. Plans such as these can impose barriers to care because they are often medically underwritten, exclude coverage for preexisting conditions, do not cover essential health benefits, and do not have cost-sharing limits (Pollitz et al., 2018). These factors will inevitably begin to contribute to unaffordable health care, barriers to access, and eventually further the increase in disparities and decrease in health outcomes.

According to the Kaiser Family Foundation, in 2010, the uninsured accounted for 46.5 million people. In 2010, with the implementation of ACA, the uninsured rate dropped fewer than 26.7 million before increased in 2019 to 28.9 million people (Tolbert et al., 2020). Unfortunately, with the pandemic, those numbers are likely going to continue to increase. According to the Commonwealth Fund, the U.S. spends more per capita on healthcare than any other country, but we boast some of the worst health outcomes. For example, the U.S. has the highest chronic disease burden and obesity rate, lowest life expectancy, and highest suicide rates (Tikkanen & Abrams, 2020).

It is unimaginable that a country as wealthy as the United States places so little importance on the health of its citizens and continues to use a free-market model that is failing the U.S. healthcare system.

A Ph.D. in Healthcare Administration will help better understand the entire framework of the United States healthcare system and ultimately help create a policy that helps support and sustain affordable healthcare options. Healthcare should be a right, not a privilege.