The Affordable Care Act: Against the Odds, It’s Working

Blog | November 9, 2020


The Patient Protection and Affordable Care Act (ACA), signed into law in March 2010, was designed to address major flaws in our health care system, including access to care, poor health outcomes, inconsistent quality, and high health care costs. It has been controversial since the beginning, and some states (North Carolina included) have chosen not to implement it fully via expansion of Medicaid coverage. But, as guest editor Pam Silberman of the UNC Gillings School of Global Health writes, despite the odds the ACA has contributed to positive improvements in our health care system.


The latest issue of the North Carolina Medical Journal looks at what the ACA has accomplished – in North Carolina and in the United States more broadly – and what is still left to be done 10 years after implementation.


Click on the links below to read each article.



Issue Brief

The Affordable Care Act: Against the Odds, It’s Working by Pam Silberman, JD, DrPH



Commentaries & Sidebars

The Affordable Care Act in North Carolina: A Look Back and Review of Coverage Changes by Ciara Zachary, MPH, PhD


Sidebar: The Impact of the Affordable Care Act on the Health of Racial and Ethnic Minority Communities in North Carolina by Ronny A. Bell, PhD, MS and N. Ruth Gaskins Little, EdD, MPH


Sidebar: After the Affordable Care Act: The National Health Service Corps Resurgent in North Carolina by Shawanda Fields, MSW and John Resendes, MA, LPA, HSP-PA, LCAS-A


10 Years Later: The Impact of the Affordable Care Act on Prevention and Public Health in North Carolina by William Brody; Kelly S. Kimple, MD, MPH; Karen Stanley, RDN, LDN; Joyce Wood, MBA; Tish Singletary; Sharon Nelson, MPH; and Susan M. Kansagra, MD, MBA


The Past Decade of Paying for Value: From the Affordable Care Act to COVID-19 by Hannah Crook, BSPH; Rebecca Whitaker, PhD, MSPH; William Bleser, PhD, MSPH; Robert Saunders, PhD; and Mark B. McClellan, MD, PhD


The Affordable Care Act in Court: Litigation Continues Unabated by Jane Perkins, JD, MPH


Overpromised and Underdelivered: Solid Wins for Hospitals Under the Affordable Care Act Overshadowed by What Could Have Been by David L. Pope, JD, MHA


Sidebar: Deepening Roots: The ACA as a Catalyst for Meaningful Community Health Collaboration by Marian Arledge, MPH and Erin Braasch, MPH, RN


A Stronger Safety Net: Community Health Centers 10 Years After the Affordable Care Act by Chris Shank, BS and Brendan Riley, BA


Focus on Philanthropy: Investing in the Affordable Care Act and Expanding Medicaid are Critical to Statewide Health by Adam Linker, MA and Laura Gerald, MD, MPH


Running the Numbers: Estimated Changes in Health Insurance Coverage of North Carolinians in the First Six Months of the COVID-19 Pandemic by Mark Holmes, PhD


Spotlight on the Safety Net: NC Get Covered – A Statewide Network of Health Care Change Agents by Willona M. Stallings, MPH



From the NCIOM:

NCIOM Affordable Care Act Task Force: Update on Implementation of Recommendations by Brieanne Lyda-McDonald, MSPH




Small and Invisible, Yet Strong and Impactful: North Carolina’s Montagnard Community Responds to COVID-19 by Saif Al Amin, BDS; Sharon D. Morrison, MSPH, MHSE, PhD; and S. Sudha, PhD