Introduction: An Overview of the ACA as a National Experiment

Abstract

The Patient Protection and Affordable Care Act (ACA) is not only landmark legislation, but it also is the largest health policy experiment our nation has undertaken in our generation. Like all experiments, it has led to more testing, building on positive results, and trying to correct negative ones. However, unlike research done in the carefully controlled conditions in a lab or clinic, the ACA is an experiment being conducted in the midst of protean real-world challenges. That means its theories and logistics are not only tested, but also subject to initial and continuing challenges of many types. This point was emphasized in the first edition of this book, and is again here, because it highlights not only the importance of learning from innovation, but also the importance of healthcare research in improving—indeed, perhaps saving—our nation’s healthcare system. We must make the case for the full spectrum of translational research—from bench to bedside to practice to public benefit to policy. Widespread understanding of the need for this entire chain will lead to better public support, including a better understanding of policy innovation.