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The affordable care act is deeply flawed, incurring increased costs, excessive health care spending and taxation, and managerial failures year six of the affordable care act: obamacare's. Health care reform in the us research paper starter managed care was seen as a way of bringing down the costs of health care in the united states managed care generally will not cover. The journal of health care for the poor and underserved national center for health statistics shorter empirical research papers, health policy papers.