Obamacare’s Flawed Priorities and the Need for Reform

Obamacare, formally called the Affordable Care Act, was sold to the American public as a transformative step toward equitable healthcare access. Yet, its fundamental flaws remain glaring. 

Nowhere is this more evident than in Obamacare’s Medicaid funding priorities and its approach to religious and moral freedoms—issues that President Donald Trump’s Health and Human Services nominee Robert F. Kennedy Jr. forcefully addressed (among other important priorities for America’s overall health) in his testimony this week before the Senate.

Kennedy has been clear in his critique of the Obamacare’s shortcomings, particularly its failure to prioritize the most vulnerable. He also highlighted that Americans simply don’t want it. 

“Americans by and large do not like the Affordable Care Act,” Kennedy said at the hearing. “People are on it, they don’t like Medicaid, they like Medicare and they like private insurance. We need to listen to what people prefer.” 

Sen. Bernie Sanders, I-Vt., interrupted, audibly laughing, and asked rhetorically “Really?” 

Kennedy doubled down and asserted, “They would prefer to be on private insurance. Most Americans, if they could afford to be, would be on private insurance. We need to figure out ways to improve care, particularly for elderly, for veterans, for the poor in this country, and Medicaid—the current model—is not doing it.”

The Medicaid Disparity: A Misguided Approach

One of Obamacare’s most indefensible provisions is its elevated Federal Medical Assistance Percentage for able-bodied adults under Medicaid expansion. Under the current framework, states receive a federal reimbursement rate of up to 90% for covering working-age, non-disabled adults—significantly higher than what they receive for traditional Medicaid populations such as low-income mothers, children, and individuals with disabilities.

Kennedy has rightly condemned this disparity as both fiscally irresponsible and morally indefensible. 

“We should be prioritizing those who cannot care for themselves—our elderly, our disabled, our children,” Kennedy asserted in his testimony. Instead, as he made clear, we have a system that favors able-bodied adults, many of whom could be working and obtaining private insurance, over those who are most in need.

This misguided policy does not just strain state budgets; it directly harms those who rely on Medicaid the most. States—facing financial pressures—are incentivized to expand coverage for able-bodied adults rather than allocating resources to seniors and disabled individuals who require more comprehensive care. The result? Longer wait times, diminished services, and a Medicaid program that fails its original mission.

The Contraceptive Mandate: Undermining Religious Liberty

Beyond the funding inequities, Obamacare’s contraceptive mandate remains another deeply problematic provision—one that has forced religious organizations and businesses into unnecessary legal battles. The Biden administration’s recent withdrawal of a proposed rule to remove moral exemptions from the mandate is a temporary reprieve, but the issue remains unresolved. 

Kennedy has warned for quite a while about the dangers of government overreach in healthcare, and conservatives generally agree that Obamacare’s failure to protect conscience rights is emblematic of broader constitutional concerns. 

No American should be forced to violate their religious or moral beliefs because of a government mandate. The legal battles waged by religious organizations like the Little Sisters of the Poor and businesses such as Hobby Lobby underscore Obamacare’s failure to adequately safeguard these fundamental freedoms.

The law must be amended to permanently enshrine robust protections for moral and religious objections. Without this reform, the mandate’s language will continue to be used as a tool of coercion rather than a policy of healthcare access.

Reforming Obamacare to Serve Its True Purpose

Obamacare was meant to expand healthcare access and reduce disparities. Instead, it has created new inequities, rewarding states for prioritizing able-bodied adults over the most vulnerable while also infringing upon fundamental freedoms.

To address these issues, Congress must act. The elevated Federal Medical Assistance Percentage for able-bodied adults should be eliminated, redirecting funds to those in genuine need: the elderly, disabled individuals, and low-income families. Additionally, the contraceptive mandate must be revised to include ironclad protections for religious liberty, ensuring that no American is forced to choose between their faith and compliance with federal law.

Kennedy has been vocal in his call for reform, urging lawmakers to fix Obamacare’s fundamental flaws rather than doubling down on a broken system. He has argued that the goal should be fairness, not favoritism, and providing pathways for Americans to get the health insurance and care they choose instead of the government choosing for them. 

If we want a healthcare system that works for all Americans, we need to rethink the policies that are creating unnecessary harm. We need to generate more competition among providers, not less.

Obamacare’s original promise—better healthcare access for all—remains unfulfilled. But it is not too late to correct its course. Congress must take decisive action to ensure that our healthcare policies align with fiscal responsibility, freedom to choose, and moral integrity. If left unaddressed, Obamacare will continue to serve as a vehicle for discrimination rather than a true care for the American people. 

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