Opponents of the Affordable Care Act made numerous assertions about the dire consequences of the legislation as it was debated in Congress in 2009 and 2010. These attacks continued after enactment as congressional Republicans made repeated attempts to repeal the law. The critics described the Affordable Care Act as a fundamental threat to the national economy and health care system. They claimed that the law would:

• “Ruin the economy” (Former Speaker John Boehner)
• “Destroy jobs and small businesses” (Former President Donald Trump)
• “Drive[] up health care costs” (Former Senator Dan Coats)
• “Bankrupt our country” (Former Speaker John Boehner) 
• “[C]ause millions of people to lose … health insurance” (Former Speaker Paul Ryan)
• “[Cause] millions of Americans … to lose their employer-provided health insurance” (Florida Governor Ron DeSantis)
• “Raid[] a half a trillion dollars out of Medicare” (Former Speaker Paul Ryan)
• “Bankrupt[] my state” by expanding Medicaid (Former Texas Governor and Energy Secretary Rick Perry)
• “[Be] a government takeover of … the health care sector” (Former Speaker Paul Ryan)
• “Erode[] the freedom of every American” (Former Vice President Mike Pence)

One member of Congress even said the law “literally kills women, kills children, kills senior citizens.”

On the tenth anniversary of the ACA’s coverage expansions, it is now clear that these doomsday predictions were wrong on every count. Not only has the ACA expanded high-quality and affordable health insurance to more than 40 million people, it aided the economic recovery from the Great Recession, eliminated the worst abuses of the health insurance industry, helped address long-standing racial and economic disparities in health care, and reduced the long-term federal deficit by $2 trillion.  

Over time, these erroneous assertions have receded from the public debate as the ACA reforms have become an accepted part of everyday life. But at the time, their relentless repetition fomented opposition and misled millions of Americans. This report, available below, evaluates 11 of the main claims made by opponents of the ACA. On each claim, the reality has been the exact opposite of what the law’s opponents predicted. The ACA brought lasting positive change to health care in America, strengthened our economy, and created jobs while also becoming the biggest deficit reduction legislation in decades.