To Improve Health Care, Fix the ACA—Don’t Dismantle It

Written By: Carrie Collins-Fadell, MPA

With the race to 2020 beginning to take shape, presidential candidates are crisscrossing the country, discussing and debating their ideas and policy recommendations, each looking to stand out from the pack by presenting their unique vision for the future of America.

It’s no surprise that health care continues to be one of the top issues for candidates and voters alike. The rising costs of health care here in Arizona and across the country is more than enough reason for it to be at the forefront of any presidential candidate’s platform. It’s most likely a concern for every Arizona family. However, in the dash to attract support, candidates should be careful not to propose policies that could have the unintended consequence of driving  costs up or curtailing critical access to care.


Concerningly, many of the calls to abandon the ACA or move toward greater government control of our health care insurance system could do just that. Whether it is Vice President Joe Biden’s inclusion of a “public option” in his health care proposal or the more extreme calls for Medicare-for-all or single-payer, voters and patient groups  should read the fine print when it comes to changes to our current health care system and the impact this could have on Arizona’s patients, particularly those who have started to see an increase in access to care under the expansions and the Affordable Care Act sometimes called “Obama Care”, such as those with pre-existing conditions.

As someone who works with families in crisis after a serious accident, illness, or injury has disrupted life as “normal”, I would be interested in the details of how a shift toward a government-run health care insurance system would impact timely access to the variety of care and specialists Arizonans recovering from brain injury need.  One of the most common brain injuries incurred by  thousands of Arizona residents each is a traumatic brain injury sustained in a motor vehicle crash.  That injury alone can require a bevy of medical specialists and therapies if one is to enter into the realm of living well after brain injury. Physiatrists, neurologists, neuro-ophthalmologist, and functional endocrinologist all are some of the specialties that enter into the survivors and caregiver’s lexicon.  There can also be a variety of speech, language, occupational, and physical, therapies needed.  While the system is far from perfect or fair,  if we enact a government-run healthcare system,  will survivors  have the same access to these valuable experts who are so vital in aiding a patient’s recovery?

Whatever the name or moniker—Medicare-for-all, Medicare buy-in, a public option, or single-payer—increasing the government’s role in delivering health care might not be the preferred road to safeguard the leaps forward started by the ACA that have managed to survive the current administration. It’s crucial to make sure we don’t end up with a one-size-fits-all government insurance system that ultimately results in fewer options, diminished access for patients, and a lower quality of care for everyone.

Rather than potentially  jeopardizing the quality of and access to care for those who are the most medically vulnerable, our leaders, or prospective leaders, should be focusing on making practical fixes to our current health care system in order to control costs and increase access. There are so many small changes that could make a big difference in the lives of those living with acquired brain injury – or any number of conditions and illnesses.

From expanding Medicaid in the states to increasing healthcare literacy,  reprioritizing education and enrollment to expanding federal subsidies to help more Arizonians get covered—we need to work on expanding what’s working with the ACA and addressing what isn’t. This could be one of the keys to tackling the high cost of health care in our country while expanding access and coverage for more of those who need it. Democrats and Republicans alike should take note.

Carrie Collins-Fadell is the director of the Brain Injury Alliance of Arizona.  You can reach her at [email protected]