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Swot Analysis – The accountable care act

Overview of Accountable Care Act

The Accountable Care Act was passed by congress and subsequently signed into law by president Barrack Obama of the United States of America on March 23, 2010. This act gives consumers powers to control their health care. The American people are able to have the comfort and flexibility they require in making of good choices on matters their health. This act ensures that the health care is of high quality and affordable to all Americans and seeks to achieve this through expansion of coverage, controlling of costs pertaining health care, and improvement of the health care delivery system.



The Accountable Care Act comes with many merits which include assured affordability, expanded Medicare, establishment of subsidy programs for low income earners as well as medium income earners, and provision of assistance to small businesses. It also brought about shared responsibility from 2014 as employers who met a certain criteria were supposed to pay $2,000 every year for their employees. The ACA made coverage to be mandatory for all Americans and legal residents as well as their dependents. Another strength in the ACA is the payment model which emphasizes improved quality and efficiency. This is possible as there is no option for public health insurance, but instead offers proposals which promote accountability

The health insurance exchanges are also a point worth noting. For instance, the establishment of coverage through multi state plans which required that insurers offer two multi state plans, one by a non-profit organization and at least one cover that does not allow for abortions that go beyond the permissible limit by the federal law

Children’s Health

The ACA ensures coverage for all children of between 6-19 years and preserves a CHIP program past 2013 that includes full funding up to 2015. It has many pros regarding children’s health which includes expansion of their access to Medicaid program that covers early screening, diagnosis and treatment. It simplifies and makes it easy to coordinate the enrollment process for Medicare and CHIP, helps secure coverage for preventive care and screening, and ensures funding of the development and implementation of maternal, infant, and early childhood home visit models based on evidence.

Racial & Ethnic Health Disparities

In the case of racial and ethnic health disparities, the Accountable Care Act guarantees in excess of $11 billion to help in  funding of community health centers and requires that the federal government take charge to note any discrepancies. It also authorizes increased funding to be used in recruiting, training,provision of other financial aid for the less fortunate students willing to pursue health careers.


Even though the Accountable Care Act has numerous strengths, it also has its share of weaknesses. One, some people can argue that the compulsory coverage of pre-existing conditions can lead to increased premiums thereby causing a domino effect. People can also terminate their insurance which can cause a further increase in premium thus leading to more expenses. Grant (2012), argues that forcing Americans to take insurance can raise a red flag in constitution and pave way for more intrusion by the government. Those opposing the ACA also claim that the “confusing language used in the health care reform law can increase the likelihood that most of Americans living on moderate incomes can be unable to afford what their employers’ family policies offer them and still be unable to qualify for government subsidies in order to obtain their own insurance”. According to Moore (2012), this development is bizarre and doesn’t meet the basic objective of health care reform which is to increase the number of people that get insured and ensure affordable coverage.


There are many opportunities that come with the ACA which include ensured access to affordable health care as millions of people without health insurance can now have access to these services. It also makes it possible for children of up to 26 years to be covered under the health insurance of their parents. Moreover, Americans who had pre-existing conditions can be guaranteed coverage as they cannot be dropped indiscriminately from their insurance.Once implemented, the ACA creates a huge demand for primary care providers. According to Fitzgerald et al (2015), there is a surplus of specialists in the US, but not of primary care physicians so the ACA helps create a real opportunity here. APNs are further trained appropriately in order to meet those demands with the bill favouring them as there will be no need to collaborate with physicians.

Other opportunities associated with ACA include increase in the number of centres run by nurses, opening up of the field of information technology due to the need for electronic medical records, and creation of new incentives while building on existing ones


There are several threats to the Accountable Care Act. According to Molinari (2014), the ACA tries to bring about stop- loss policies. As employers act as insurers and bear the risk of their employees’ health care costs in place of buying health insurance coverage from companies providing insurance, the ACA exempts such plans from most of its reforms. This creates gaps for employers who seek to avoid to comply with the law. The ACA meets many challenges as there are bill being tabled to oppose quantifiable areas in the bill and there have been repeated calls to repeal the ACA mostly by the Republicans who support the “Ryan Budget” and are more than determined to change the Medicare into a voucher program (, 2015). Some religious groups also oppose the ACA claiming that it’s a threat to their liberty as they resent to take part in women’s right to choose. Further, there are states that refuse to expand the Medicare program to comply with the ACA


Several documentations indicate that even though America is among the richest countries in the world, they have their health care system which is not the best and is poorly structured. Even though, they have a very impressive pool of primary care providers in APNs that are underutilized and by the ACA ensuring health coverage for millions of uninsured Americans, it creates an opportunity for the APNs to practice fully in their sphere.



Community Catalyst, (2015). Community Catalyst. Retrieved 9 September 2015, from

FITZGERALD, M., BIAS, T., & GURLEY-CALVEZ, T. (2015). The Affordable Care Act and Consumer Well-Being: Knowns and Unknowns. Journal of Consumer Affairs, n/a-n/a. doi:10.1111/joca.12059

Medicaid: Its Role Today and Under the Affordable Care Act. (2012). JAMA308(8), 752. doi:10.1001/2012.jama.10159 (2015). CMA || Center for Medicare Advocacy, Inc... Retrieved 9 September 2015, from

Molinari, C. (2014). Does the Accountable Care Act aim to promote quality, health, and control costs or has it missed the mark? Comment on “Health system reform in the United States”. International Journal of Health Policy and Management2(2), 97-99. doi:10.15171/ijhpm.2014.23

Obamacare Facts, (2015). Affordable Care Act Summary. Retrieved 9 September 2015, from

U.S. Department of Health & Human Services, (2015). About the law. Retrieved from

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