It’s easy to take for granted a law passed in March 2010. But on the Affordable Care Act — the greatest overhaul to the nation’s health system, and particularly Medicaid, since 1965 — it’s worth taking a look back.
Let’s start with the latest: Marketplace plan enrollments are at record highs, according to the U.S. Department of Health and Human Services’s 2022 Open Enrollment Report. More than 14.5 million Americans accessed health insurance through federal or state exchanges, a 21% increase from the 2021 OEP.
Medicaid, which was expanded by the ACA to households making up to 138% of the federal poverty level in most states, has even more to celebrate. A record 85.9 million Americans, as of November 2021, receive health insurance through Medicaid or CHIP.
We’re proud to have helped some of them secure it. And so, in fact, are the majority of voters.
How the ACA Won Over America
No longer are the ACA or its programs controversial. The Supreme Court has upheld the law not just one, or two, but three times. More than seven in 10 Alabama voters support Medicaid expansion — a margin unheard of for a “blue” issue in a conservative state.
The ACA is popular because it’s improved Americans’ lives. Medicaid Expansion alone has prevented 19,000 premature deaths, never mind those prevented by exchange plans or essential coverage provisions.
Again, it’s easy to take for granted a law passed a decade ago. Before the ACA, not all plans covered the 10 categories of services deemed essential health benefits. Insured Americans were frequently denied coverage for needs like mental health, prescription drugs, and pregnancy.
While expanding benefits, the ACA has also kept a lid on out-of-pocket costs. Costs for those with health insurance under the ACA have slowed by 80%, rising at an average of 0.2% per year — far less than inflation — since 2010. Medicaid and CHIP enrollees pay little or nothing out of pocket.
The ACA has saved lives, increased access, and controlled costs. Despite attempts to undermine it, it’s one of the federal government’s key successes of the 21st century.
Biden’s Vision for the ACA
For the ACA’s 12th birthday, President Biden announced a special enrollment period for Americans making less than 150% of the federal poverty level. Biden continues to pursue, HHS Secretary Xavier Becerra said in the announcement, health care as a right for all.
In 2021, 45% of those who signed up for coverage on the ACA’s federal exchanges had household incomes of less than 150% of the poverty level. The SEP will lower barriers to coverage for a key ACA target demographic, the same goal behind Biden’s recent move on Medicaid.
In February, Biden rolled back Medicaid waivers that allowed states to charge premiums to enrollees. The administration cited studies showing that they lead to fewer sign-ups and re-enrollments.
The ACA is far from perfect, but it’s made enormous progress toward President Biden and former President Obama’s vision. While more than 30 million Americans remain uninsured, it’s important to remember roughly 48 million were prior to the ACA. Its place in the American healthcare system is sealed, and universal coverage is no longer a pipe dream but a platform plank of mainstream political candidates.
However you and your employees get health insurance — through your company’s group health plan, on the exchanges, or through Medicaid — it’s better because of the ACA. Thank you for taking a few minutes to appreciate it.