REFORM Obamacare Coalition

The coalition has assembled one of the most expansive bodies of research on the ACA’s architecture and how its individual provisions have reshaped healthcare. From that foundation, we identified the five worst symptoms of Obamacare, then tasked a team of healthcare policy experts with tracing each problem back to its real causes. For every symptom, REFORM Obamacare provides a clear diagnosis and a practical set of prescriptions lawmakers can enact to reduce harm, restore competition, and protect patients.

Healthcare is arguably the most complex policy field in America. It is heavily regulated, intensely lobbied, and deliberately opaque, making it difficult for everyday Americans to understand what is happening, who benefits, and what reforms would actually improve care. While many organizations have produced valuable work, most have been forced by scale and specialization to operate in silos, focusing on a single area such as Medicaid, insurance regulation, pharmaceuticals, PBMs, or provider consolidation. REFORM Obamacare fills what has been missing: a comprehensive, evidence-driven framework that connects these issues into a coherent picture of cause and effect.

To make that possible, REFORM Obamacare built a detailed policy index that breaks down the ACA provision by provision and maps how the law’s incentives interact across the system. This approach allows policymakers and citizens to see what fragmented analysis often misses: how a “fix” in one lane can worsen outcomes in another, and how complexity creates opportunities for entrenched interests to extract value at the expense of patients and taxpayers.

Our reform agenda is designed to solve the worst problems Obamacare created and move healthcare toward lower costs, higher-quality care, and greater innovation by applying limited government and free-market principles wherever possible. To separate serious reformers from those protecting the status quo, the coalition has also launched the Obamacare Scorecard: the most in-depth analysis of lawmaker healthcare voting to date, powered by the Institute for Legislative Analysis. Americans deserve to know whether their elected officials are advancing patient-centered, limited government reforms or doubling down on a system that keeps getting more expensive, more consolidated, and less accountable.