On March 23, 2010, the Affordable Care Act (ACA) was signed into law, the most significant national healthcare reform in the United States in about half a century.
Though its goal is to provide all U.S. citizens with health insurance, the ACA has hit some stumbling blocks over the decade since it was first signed into law by President Barack Obama.
Used as a political punching bag, “Obamacare” has faced multiple threats of being repealed by Republican politicians, many of them happening over the past 3 years during the Trump administration.
Today, its fate is once again imperiled by the fight to fill an open Supreme Court seat following the death of Justice Ruth Bader Ginsburg, compounded by a contentious presidential election.
On top of all this, the COVID-19 pandemic is putting unprecedented strain on our nation’s healthcare system.
Once again, healthcare is at the center of American politics.
Often lost sight of in all of the political debates is the fact that the ACA has made healthcare available to millions more people. Because of the ACA, affordable coverage is accessible to Americans with lower incomes, people who are unemployed, and those living with preexisting conditions, like chronic illnesses.
While the ACA has become a key part of healthcare for millions of Americans, it has remained at the center of political discourse.
Yet a lot of people are still confused about what it is, how it works, and what possibilities are out there to expand and improve it.
Here’s an overview of where the ACA stands in 2020, a decade after its introduction, and what may happen to healthcare for millions of Americans if it’s soon repealed.
What is ‘Obamacare’ and how does it work?
A 2010 article in the journal Health Affairs calls the ACA “the most important health care legislation since the 1965 law that created Medicare and Medicaid.”
Despite this historic significance, many people don’t really know what this health legislation even is.
The ACA essentially is the name for the overall health reform legislation signed into law in 2010.
It was enacted in two parts: the Patient Protection and Affordable Care Act, signed into law on March 23, 2010, and the Health Care and Education Reconciliation Act, signed days later on March 30.
To expand coverage to as many Americans as possible, the legislation was designed to address several perceived gaps in America’s existing health insurance system.
One was to provide tax credits to lower healthcare costs for households with incomes somewhere between 100 percent and 400 percent of the federal poverty line.
The second was to expand Medicaid coverage to U.S. adults with incomes 138 percent below the poverty level.
One caveat of this is that not all states have expanded Medicaid. Right now, 38 states and the District of Columbia have adopted Medicaid expansion, the Kaiser Family Foundation (KFF) reports.
This expansion of services to people and families with low income levels has been shown to be a great boon to overall public health. A recent study found that Medicaid expansion led to earlier cancer detection rates.
Additionally, the ACA put in place several healthcare delivery system reforms to help lower costs overall.
How do you get “Obamacare” coverage? Every year there is an open enrollment period for coverage that begins January 1 of the upcoming new year.
To apply for a health insurance program, you need to go through the Health Insurance Marketplace, where you are able to see what plans are available in your state. Some states run their own marketplaces, once known as “exchanges.”
For 2021 coverage, the enrollment period runs from November 1 to December 15 this year.
If you miss the deadline, certain situations might allow you to qualify for a “special enrollment” period. For instance, maybe you had a child or lost your job.
People who qualify for Medicaid or the Children’s Health Insurance Program (CHIP) can apply for a plan at any time.
Once you’re on your plan, it will run for the rest of the year. You can then renew your plan during the next enrollment period the following fall.
A report from earlier this year showed that 8.3 million people either signed up for or renewed health insurance via the ACA for 2020 coverage.
Source: Health Line