Researchers find that repealing or revising ACA would be challenging

Etti Baranoff, Ph.D.
Etti Baranoff, Ph.D.

In response to calls to eliminate the Affordable Care Act of 2010, a group of researchers led by Etti Baranoff, Ph.D., associate professor in the Virginia Commonwealth University School of Business, has released a study depicting the large-scale structure of the U.S. health care system before and after the ACA. The study found that the decline in employer-sponsored group plans coupled with the increase in Medicaid participation has reshaped the health care system, providing a challenge to repealing efforts.

The study, “What US Health Insurers’ Data Show for ACA ‘Repealers,’” published in the latest issue of The American Journal of Accountable Care, reveals that some of the trends began before enactment of the ACA, likely as consequences of other factors such as the 2008 financial crisis, which left major unemployment in its wake.

One resulting prominent trend is the continuous reduction in employer-provided group health insurance despite a reversal in unemployment. While such a reduction can be expected at the start of a recession, it’s unusual that it continued after the economy rebounded.

These trends help provide a picture of the developing status of health care plans’ membership and utilization, which will inform any discussion of changes in, or repeal of, the ACA.

“In seeking possible explanations for the trends we found,” the study reads, “we must look beyond the ACA, as these trends were in evidence before the ACA was enacted. The ACA may or may not have enhanced the trends, but other factors were also in play, one surely being the Great Recession during the late 2000s, which reduced employment and cut off former employees from access to group insurance.”

About VCU and VCU Health

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 217 degree and certificate programs in the arts, sciences and humanities. Thirty-eight of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 11 schools and three colleges. The VCU Health brand represents the VCU health sciences academic programs, the VCU Massey Cancer Center and the VCU Health System, which comprises VCU Medical Center (the only academic medical center in the region), Community Memorial Hospital, Children’s Hospital of Richmond at VCU, MCV Physicians and Virginia Premier Health Plan. For more, please visit and