- The 900-page-plus bill aimed to curb swelling health-care costs, increase quality and flip more than 30 million Americans from uninsured to insured.
- What happened next, of course, didn’t go as planned.
- Here’s how the law succeeded and failed.
The Affordable Care Act has been the law of the land for close to a decade, and yet it can seem that we’ve barely settled into it.
Headline after headline warns its existence is in jeopardy. Many states refuse to implement its core parts. President Donald Trump has wished for it to explode. A central provision has been declared unconstitutional.
Former President Barack Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010, saying the legislation codified the idea in the U.S. that “everybody should have some basic security when it comes to their health care.”
The bill, totaling more than 900 pages, aimed to curb swelling health-care costs, increase the quality of that care and flip more than 30 million Americans from uninsured to insured.
What happened next, of course, didn’t go as planned.
Recently, a federal court decided the central provision of the Affordable Care Act requiring all Americans to be insured or face a tax penalty is unconstitutional. Now, the entire law may be in limbo. Congress just repealed three taxes meant to raise revenue for the ACA.
In 2012, the Supreme Court ruled that Congress had exceeded its constitutional power by requiring states to expand Medicaid — one of the main ways the law aimed to increase coverage rates. At least 14 states have refused to expand their Medicaid program since.
“Changes to the ACA have come from many different quarters, including Congress, the administration, state governments and the federal judiciary system,” said Christine Eibner, a senior economist at the RAND Corporation, a nonprofit think tank. “Many of these changes have reduced the law’s reach in terms of expanding coverage.”
Indeed, some 28 million Americans are still uninsured.
Even so, the Affordable Care Act has made our health-care system unrecognizable from a decade ago.
“I’d say, in many ways, the goals have been closer to met than not,” said Gregory Stevens, associate professor of clinical family medicine at the University of Southern California.
The Affordable Care Act established health insurance marketplaces, including Healthcare.gov and state exchanges at which people could sign up for coverage and potentially qualify for federal subsidies. Despite initial spikes in prices on the marketplace, premiums have grown more affordable over the last couple of years.
“The tax credits have proven to be a very stabilizing force in the individual market,” Eibner said.
More than 20 million Americans gained health insurance under the ACA. Black Americans, children and small-business owners have especially benefited.
Thirty-seven states have expanded Medicaid, deepening their pool of eligible residents to those who live at or below 138% of the federal poverty level. As a result of the increased access to health care, it’s estimated that more than 19,000 lives have been saved.
The Medicaid expansion is popular with voters. After Louisiana Gov. John Bel Edwards, a Democrat, won reelection in November, his lead pollster told The Washington Post that “no single issue was more important than the Medicaid expansion.”
Source: CNBC