WASHINGTON, DC: Former President Barack Obama and President Joe Biden shake hands at an event … [+]
The United States Department of the Treasury announced today, September 10, that nearly 50 million people have obtained health care coverage through marketplace exchanges created by the Affordable Care Act since its enactment more than a decade ago. This is evident from the department’s data one in seven Americans fall or fall under the law. And since President Biden was inaugurated in January 2021, 18.2 million Americans have gained ACA coverage for the first time.
The increase in enrollment since 2021 has been driven by an expansion under the Biden administration of premium tax credits to individuals and families with household incomes up to 400% of the federal poverty level, which amounts to $58,000 for a single person and $120,000 for a family of four.
The ACA has had a tumultuous history since it was signed into law in 2010. Republicans have repeatedly called for the law to be repealed. Yet the ACA is now more popular than ever, with more than 60% of the public who have a positive image of the legislation, according to KFF.
The ACA is a comprehensive reform bill, passed by Congress in 2010, that expands health insurance coverage for the uninsured and implements a wide range of reforms to the health insurance marketplace, as well as an expansion of Medicaid, the public insurance program that provides health care coverage for families and individuals with low income. Importantly, individuals who may be uninsured due to pre-existing conditions or limited finances can obtain affordable health care plans under the ACA through the health insurance marketplaces established by the law.
The legislation has its critics. They point to certain ones defects in design and implementationIn the first years of the Obama administration, insurers left the market en masse and premiums rose substantially. The ACA was not nearly as popular then as it is now.
Under the Trump administration, ACA registration fell while the number of uninsured rose by more than two million. After failed attempts to scuttle the ACA, the president issued executive orders to “improve ACA market dynamics.” ACA exchanges did stabilize in the second half of Trump’s term, when insurers returned and the pace of premium growth slowed.
When Biden took office, he sought to expand the ACA program and undo some of the changes implemented by the Trump administration that had shrunk its size. As a result of the aforementioned premium tax credits provided to eligible enrollees and a provision included in the Inflation Reduction Act passed in 2022 that includes expanded subsidies for plans that sell insurance on the ACA exchanges, record numbers of Americans are now enrolled in health care plans associated with the ACA.
As such, the ACA has achieved its primary goal: reducing the number of Americans without health insurance. The percentage of uninsured nationals is currently at a historically low level 7.7%.
Fifty million people now have health care coverage thanks to the ACA. During her campaign, Harris praised the achievements of the administration she was part of, including strengthening the ACA. She also wants to expand this policy, in addition to expanding the scope of Medicare drug pricing provisions in the IRA.
The perennial problem for Republicans who wanted to get rid of the ACA is that the law contains provisions that are popular with voters. These include guaranteed coverage and community assessment for people with pre-existing health conditions; subsidies for individuals purchasing health insurance on the federally administered state exchanges; and allowing people under 26 to remain on their parents’ insurance plans.
Accordingly, it is highly unlikely that Trump will attempt to overturn the ACA if he wins the November election. It is much more likely that he would try to reform the ACA and mold it after what his allies have been pleada leaner program and one in which individuals have control over the ACA subsidy they qualify for, rather than the government dictating which benefits should be included in insurance packages purchased on the marketplace.