2016 Seidman Lecture: How the ACA Is Working, and What To Do Now

November 4, 2016

Joseph Newhouse, Peter Lee, Barbara McNeil 

Written by Katherine J. Igoe

October 25, 2016—The 16th annual Seidman lecture was a call to action for more research about the effects of the Affordable Care Act.

The lecture came during a particularly critical time in the lifespan of the ACA. Open enrollment for Obamacare started on November 1, amidst reports of increasing premiums and fewer options in the Exchanges.

But Covered California (the state’s ACA insurance marketplace), has been one of the most successful states in implementing the ACA, serving 2.5 million consumers and providing 1.1 million Californians with coverage since 2014.

During the lecture, Peter Lee, executive director of Covered California, challenged researchers: “You need to help us answer questions, and help the new Congress and the new president build on what we've got—which is actually working pretty well."

Lee noted that many HCP faculty members have made fundamental theoretical and practical contributions to the development of the Affordable Care Act, and that they will play a key role in building on the accomplishments of the ACA.

“Credit and blame lie on your doorstep,” he said, “which means the solutions fall on your doorsteps.”

After the talk, Lee explained that he wants research to tackle what effects the ACA has on the current policy landscape.

“We need to ask the next generation of questions: how to deal with issues of consolidation, how to deal with issues of changing payment, which are exactly what we need to be dealing with,” Lee said.

In particular, he argued that much of the needed research is still in its infancy, noting that little is known about how incentives work for individuals seeking coverage, what benefit designs will enable consumers to get the best access, and the potential negative effects of policies promoting provider integration and other forms of consolidation.

“We’re seeing the effects of increasing pricing that may be washing away any of the benefits. How to have both consolidation that is good for integrated care and doesn’t just lead to higher prices is a huge question that is hitting us on the ground,” Lee said.

In addition to the lecture, Lee met with HCP faculty individually to elaborate on the practical, real-world effects of the ACA in his state and the critical research that is still missing.

Joe Newhouse said the news was strikingly positive. “Peter’s management of Covered California shows that public exchanges can be made to work.”

Stuart Altman, dean of the Heller School at Brandeis, went further: “The way California runs their exchanges is second-to-none. We do a good job here in Massachusetts, but what Peter Lee has done is really phenomenal.”

New HCP faculty member Tim Layton said the talk gave him ideas for future research. “I thought the most striking thing about the talk was the importance of marketing to have a good risk pool and also just generally to get people onto the Exchange.”

Tom McGuire said the potential for economic analysis was striking. “The standard analysis of this doesn’t have a role for advertising or price for affecting people moving in and out, but you could introduce the idea of advertising and how that would work in a market.”

“It seems like a really important thing that no one’s really talking about,” Layton added.

For more information about the Seidman program, please click here

Photo by Tony Rinaldo.

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