ACA There have been many problems with the Affordable Care Act since its inception. When it was a bill, it was contested, and the final form of the law reflected a lot of compromises that weakened it. Then there was the rollout fiasco in the autumn of 2013, with site crashes preventing people from signing up (Cohen, 2013). While people are now able to sign up, a lot of people who are supposed to be enrolling are not, yet another twist in the saga (Le Masurier, 2014). Beyond all of this, there is still the question of the impact that the bill will have on the medical system -- adding millions of new patients without increasing capacity is a recipe for disaster by any standard of operations management. Some people are paying more money for less coverage, and the tighter coverage for seniors under Medicare, under the guise of cost-cutting, displeases many who cannot afford to supplement Medicare at their age. So when we are talking about the Affordable Care Act, we are not talking about just one problem, but a litany of problems, all of which threaten to undermine the original intent of the act, which was a twin objective of providing more health care to Americans and lowering the cost of health care provision.

It is almost a challenge to distill this down to a single problem. The Affordable Care Act had flaws built into it from the outset, partly because of the core concept and partly because of the compromises that were built into the law. The question now is whether or not the benefits of the Affordable Care Act outweigh the costs. It's a tricky question to answer because the law was always flawed, and because we do not yet know all of the costs associated with the law. There are benefits, but since they come at a high cost, the question has to be asked if we should overhaul the law or not, given that we now have a much better sense of what it is, and what it isn't. We know that the negative aspects affect many seniors and those within the health care industry, some businesses and some young people. We also know that the benefits are accrued by the previously uninsured and the individual mandate. For the next few minutes, I will explain how this can be achieved.
Individual Mandate

One of the most contentious parts of the Affordable Care Act is the so-called individual mandate. Narrowly surviving a Supreme Court challenge, this element of the law requires people to purchase some form of health insurance, if they do need receive this from their employer. The individual mandate, however, comes with minimum coverage standards that for many people are a) more than what they need and b) more expensive than they can afford and would have otherwise purchased (Kasperkevic, 2014). As many young people are avoiding enrollment because they cannot truly afford it, nor justify the economics of it, there is the risk that the program will be unsustainable going forward -- or premiums for those who have coverage will increase sharply. There are several solutions available to remedy this problem.

The first solution is to work within the existing framework of the law, by extending the tax relief and other credits that help the underprivileged to pay for Obamacare. This solution solves the problem of poor registration, but it causes two other problems instead - subsidizing people who aren't actually underprivileged, and costing the taxpayers more money.

A second potential solution is to beef up enforcement. This will cost more money, and essentially uses public funds to bump up the revenues of private enterprise (insurance companies). This is not a great use of public money and effort, unless a simple enforcement mechanism (through the IRS, for example) can be devised. In lieu of a proven, effective mechanism, however, this option holds little appeal. Besides, the problem isn't that not enough people are…