The Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act, also known by other names such as the Affordable Care Act, ACA, PPACA, Health Care Reform, and even ‘Obama Care’, was signed into law by President Barack Obama in 2010 and went into effect on March 23, 2010. There are many goals of the Affordable care act but its three primary goals are improving the quality of health care to lower costs, increase the access to health care, and to provider better consumer protection in health care. (Fitzgerald, Bias and Gurley-Calvez) Other goals include making health care more available and more affordable to everyone, regardless of socio-economic status, and expand the Medicaid program. There are several changes in the Affordable Care Act in comparison to pre-ACA plans such as health insurers can no longer impose waiting periods or deny coverage due to pre-existing conditions, dependents have the ability to stay on their parent’s plan until they reach age 26, insurers can not charge more in premium based on gender, and all plans must include benefits for essential health care services. Along with these changes, individuals are able to obtain coverage through the health care marketplace to obtain premium subsides to lower their premiums based on their income or cost share reduction to lower their out of pocket expenses based on their income.
With all the positive changes that the Affordable Care Act includes, it still has caused quite a commotion among politics. The views on the Act were quite different between political parties. Most Democrats voted for the changes proposed in the Affordable Care Act but no Republican voted for the Act in congress and, to date, Republicans have voted to repeal the health care law over 60 times. (McCabe) President Barack Obama presented his plans for health care reform in the 2008 presidential election and his plans to improve health care greatly contributed to his campaign and election. Making health care more affordable and available to everyone appealed to much of the U.S. population. That being said, why is it then that there has been so much controversy over the Affordable Care Act? The controversy defined a definite split between Democrats and Republicans.
There were many positive results after the Affordable Care Act went into effect. Young adults between the ages of 19 and 25 saw a large increase in the number of insured individuals. With the elimination of pre-existing waiting periods a total of 130,000 Americans were finally able to enroll in health coverage. (Glied and Jackson) Health insurance plans were required to offer benefits for maternity without additional costs, preventative care services covered at 100%, and additional benefits for pediatric vision and dental. What was the result of the addition of all these benefits? A drastic increase of premium for many of the individuals that had already been insured. Although those that showed financial need due to income or poverty level obtained health care at a substantially low rate, those that did not qualify for any premium subsidies or cost share reductions saw a huge increase in premium. In 2013 the average premium for women and men age 23 increased 44.9% and 78.2% respectively. (Premium Increases under ACA, 2010 – 2014) The individuals that had been previously insured and paying for the plans that they had chosen with relatively low deductibles and out-of-pocket amounts were now paying a drastically higher premium and also had higher deductibles and out-of-pocket maximums. Many Americans felt as though they were being punished for having continuous coverage and for making a decent income. Americans also felt as though they were picking up the slack for those who were not paying full premium or had lower cost share based on their income. A large amount of individuals benefited greatly from the implementation of the Affordable Care Act but many were left making the decision of paying their health insurance premium and making their house payment after seeing such large increases.
Just as health care reform played a large role in the 2008 presidential election, it also played a large role in the 2016 presidential election where President Donald Trump won. One of his proposed objectives was to repeal the Affordable Care Act. This drove the wedge between democrats and republicans even deeper. A majority of Republicans were against the Affordable Care Act and leaned strongly towards its repeal while most Democrats were still for the changes. News and social media went wild after President Trumps election with debates and arguments for and against the Affordable Care Act and much of the discussion was very much misinformed. It wasn’t long after President Trumps victory that he started making changes to the Affordable Care Act. In October 2017 it was announced that the government will no longer fund cost share reduction. Although insurers are still required per the ACA to offer the reduction to lower income members, they will have to pay out of their own pocket to fund the reduction. In December of 2017 a bill was passed stated that the IRS will no longer charge a tax penalty to those not having a qualifying health plan effective 2019. (eHealth) Although these are seemingly small changes, they still have a large effect on cost for both health insurance companies and the insured. One major goal of the Affordable Care Act is to make health insurance more affordable but, for many, that has not been the case making it considered a serious issue.
There are no organizations that are directly dedicated to the Affordable Care Act but, many organizations have publicly stated their stance on the issue. Many health care and Medical Associations are for the Affordable Care Act. Organizations and associations such as the American Academy of Physician Assistants, Academic Medical Centers, and the American Medical Association, along with many others, are in support of the Affordable Care Act as it allows thousands of Americans that previously were uninsured access to affordable health care. (Complete List of Groups that Support this Health Care Bill) Many more conservative groups however, are opposed to the Affordable Care Act. With all the debating and arguing aside, health care issues and health care reform is a serious issue that needs to be addressed.
Despite the implementation of the Affordable Care Act and the positive impact it has had on many Americans, health care costs are continuing to rise and health insurance premiums for those not eligible for subsidies or cost-share-reduction are rising quickly as well. Repealing the Affordable Care Act completely would return health insurance coverage to the state it was prior to the reform with 16% of Americans left uninsured. (Glied and Jackson) Many critics have suggested omitting or replacing some provisions that contribute to the rise in premiums but retain others that many have benefit from.
The Affordable Care Act has played a large role in both the 2008 election and the 2016 election. It has caused a large amount of controversy between political parties and on news and social media. Hundreds of thousands of Americans have benefited greatly since its implementation by finally being able to obtain health care coverage with essential benefits at an affordable cost. On the other hand, many Americans have seen a dramatic increase in premium and out-of-pocket amounts for benefits they had previously opted out of intentionally to lower their premium. Health care reform still needs a lot of work and research and political parties need to set aside their differences and work together to find a better solution to more available and affordable health care coverage.