Building on What’s Working: America Has the Foundation to Transform the Next Generation of Health Care Access 
COMMENTARY

April 3, 2023by Lauren Crawford Shaver, Executive Director, Partnership for America’s Health Care Future
Building on What’s Working: America Has the Foundation to Transform the Next Generation of Health Care Access 
(Dreamstime/TNS)

Since the enactment of the Medicare and Medicaid Act in 1965, rising health care costs have made it difficult for Americans to afford necessary medical care, leaving many without access to crucial services. However, various programs, such as employer-sponsored insurance, Medicare, Medicaid and individual coverage plans have helped countless patients access the high-quality care they need.  

Our nation has seen the overall uninsured rate steadily decrease through health care system innovations like employer-sponsored insurance, not from a one-size-fits-all approach. During the most recent Open Enrollment Period, 16.3 million Americans gained health care coverage through our current system (more than ever before), resulting in an all-time low uninsured rate. Despite coverage changes from the passage of the Affordable Care Act and the COVID-19 pandemic, ESI has most notably remained stable. It suggests that these health coverage innovations effectively provide millions of Americans with consistent coverage options.   

While we work to lower the uninsured rate even further, we should look to what has worked in the past. A study found that Medicaid expansion remains one of the most effective ways states can reduce their uninsured rates. If the remaining states who don’t use the federal marketplace were to expand Medicaid, over 1.76 million individuals could become newly insured. A study from the Kaiser Family Foundation estimates that nearly 4.4 million Americans could gain health care coverage through full Medicaid expansion. This expansion would result in comparable coverage gains among vulnerable populations compared to the public option — and do so without threatening Americans’ private coverage options. As we consider increasing access to coverage, we should focus on building on the resources our current system has in place. 

Private plans and public programs like Medicare and Medicaid have covered patients by providing reliable and consistent insurance coverage. So much so that support for fixing our current system (67%) has increased and surpasses support for government-run proposals. Furthermore, most U.S. voters (76%) would rather build on the nation’s current system than create a public option. Last year, six in 10 Americans (62%)said they prefer a personal option in health care that allows more choices than Medicare for All that would end private insurance.  

Our current health care system has been instrumental in improving the lives of millions of Americans, providing them with the health care coverage and support that they need to stay healthy and productive. As senior leaders in the Senate recently indicated, there’s momentum in Congress to expand on our current system to ensure more Americans can access quality care. It is time to lead a national conversation about providing individuals with what they want from their health care — access to affordable, high-quality health coverage and care.  

Programs such as employer-sponsored insurance, Medicare, Medicaid and individual coverage plans have collectively contributed to increasing access to health care for individuals and families. These programs have made health care more affordable and accessible, ensuring that people have the resources they need to maintain their health and well-being. While there is still work to be done to improve health care access and coverage, we should focus on building on and improving our current system, which includes these programs, to ensure all Americans have access to the high-quality care they deserve. 


Lauren Crawford Shaver is the executive director of the Partnership for America’s Health Care Future. The partnership’s mission is to build on and improve what’s working — where private coverage, Medicare and Medicaid work together to expand access to coverage and care — and fix what’s not. You can reach the P4AHCF on Twitter.

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