The Affordable Care Act and the Future of Health Care Reform (Part II of II)

This course will explore the Affordable Care Act in depth and then turn towards future health reform efforts and the future of the American health care system. Part II of II.

About The Course

The American health care system has many problems. 50 million people are uninsured. Quality is extremely uneven, with peaks of greatness at leading academic centers but overall poor quality in both process measures and outcomes such as asthma deaths. Finally, the U.S. health care system spends over $8000 per patient per year, nearly double the next highest country. In March 2010, the Affordable Care Act was enacted. Over the next decade or more, the Act will dramatically re-structure the American health care system.

This course will explore the challenges that were overcome to achieve health reform in America. We will delineate the specific ways that the Affordable Care Act improves access and quality, and will control costs. It will conclude with predictions about further reforms and about the future of health care in America. 

This class is open to anyone interested in gaining a better understanding of the Affordable Care Act and possible future health care reforms. While not required, we recommend you first take Part I of this course for background knowledge about the American health care system. Students who feel as though they have a strong grasp of the structure of the current US health system and the history of health care reform in the US may start with Part II.

Frequently Asked Questions


  • Will this content be available after the course is over? 
    Yes, we intend to maintain this information online.
  • Will I receive college credit for this course?
    Coursera and the University of Pennsylvania do not provide college credit for this course, however, students who satisfactorily complete the course requirements will receive a certificate of completion.
  • How many students are in this class?
    This information reaches a large number of people.  In the summer of 2012, 17,246 people were signed up to take the course on the first week of lectures and 31,967 people were registered by end of the course.  However, of those students, 3,428 submitted the first assignment and 1,066 submitted the final assignment.  1,340 people completed at least five assignments and 1,023 people passed the course.  While there is more attrition than in a traditional classroom, this is in part due to the online, free aspect of the course as people may sign up who are curious, but are not interested in completing the course. This course offers significant flexibility for students in terms of not only when you do the work, but also how much you complete.  Some students wish to learn as much as possible about the topic while others are interested in learning only a portion of the material.  Students complete the work because they are genuinely interested in learning the material.
  • I joined the class late.  Can I still participate? 
    The top 5 of 6 assignments are calculated for your grade.  Thus you may miss 1 assignments without impacting your grade.  Even if you joined too late to pass the course, you may participate in the class at any point by watching the videos, reading the material, and participating in the forums. 


  • Why did you select these readings?
    The readings are limited to those which are freely available to the public, to facilitate anyone participating in the course.  Students widely range in their background and health care experience.  Thus, while the selected readings are generally at college level, they assume a student will have only a basic understanding of the American health care system.  Additional optional readings are provided for those who wish to delve deeper into a particular topic.
  • Why do you have optional readings?
    Some people may be interesting in learning more about a topic.  For those students, we have identified optional readings.  These optional readings provide background material or more in-depth information on a topic.  You will be graded only on information in the required readings.


  • I can’t complete an assignment.  Will I fail?
    The top 5 of 6 assignments are calculated for your grade.  Thus you may miss 1 assignments without impacting your grade. 
  • How will I be graded?
    You are given one assignment each week.  The top 5 of 6 assignments are calculated for your grade.  Thus you may miss 1 assignment without impacting your grade.  For each assignment, you will be graded by a minimum of four other people.  The high and low score for each assignment will be tossed out and the other scores averaged.
  • Am I required to participate in the forums?  Are the quizzes graded?
    Participation in the forums and quizzes available through the video content are not graded.
  • How will I grade others?
    Reviewers will receive a grading rubric and sample answer.
  • How will you ensure that the grades are fair?
    We expect students are motivated to participate in their education and we ask that everyone grade each other in an objective, fair, and unbiased manner.  Grading will be double-blind; graders will not know whose work they are grading, and students will not know who graded their work.  Each assignment is graded by several different people, which will reduce any potential bias, with the high and low scores dropped for each student.  Furthermore, the selection of assignments to grade for each person will be random each week, so any given student is unlikely to have his/her work graded by any given student grader more than once.  Finally, we will be checking the grading for consistency (e.g. by comparing against grades assigned by the instructor to a few "sample" assignments).
  • Why do you require students to grade each other?
    This course is freely available on the internet.  During the summer 2012 course, 31, 967 students signed up for the course.  Coursera and the University of Pennsylvania are not able to support providing this course free for everyone without utilizing innovative and non-traditional grading mechanisms.  We also believe that in grading each other, you will learn the material better.
  • What happens if I grade more assignments one week than the minimum required?  Will I get extra credit?
    You will receive the appreciation of your classmates and hopefully a greater understanding of the material.  You will not, however, receive any extra credit.
  • Can I grade extra assignments one week to make up for grading fewer assignments another week?
    No.  You are required to grade a minimum of five assignments each week.


  • Please provide a spell-check option.
    Until Coursera is able to provide this option, we suggest that you draft your answer in Word, spell-check it, and then copy and paste your answer into the answer box.
  • How do I copy my answer into the assignment submission box?  It does not work.
    This is possibly a browser issue; Coursera is optimized for Google Chrome.  Try using the command keys to copy and paste your answer from Word: Ctrl-A (highlight all), Ctrl-C (copy), and Ctrl-V (paste).
  • How do you close the window for the multiple-choice question to resume the lecture video after the quizzes pop up?
    This is possibly a browser issue.  Coursera supports modern web standards and the many devices that run browsers that support these features.  Chrome, Firefox, IE (9-10), and Safari meet these requirements.  

Recommended Background

No background is required; all are welcome.