When it was passed a decade ago, the Affordable Care Act ushered in sweeping reform to the nation’s health insurance system. Among many other things, the ACA increased coverage options, made sure families get value for their premium dollar and helped consumers hold health insurance companies accountable. Despite its flaws, the ACA is changing people’s lives in significant ways.
In a time when many people still lack health insurance or find it unaffordable, the ACA has helped millions gain access to coverage through the individual and small business marketplaces and expanded the Medicaid program. Moreover, the ACA eliminated the penalty for going without health insurance, reducing the number of Americans who are uninsured by 24 percent since 2010. It also reduced the share of nonelderly adults who skipped needed medical tests and treatments because of costs.
Lastly, the ACA requires insurers to cover a set of essential health benefits (EHB), such as preventive services, maternity care and coverage for individuals with mental illness, substance use disorders or developmental disabilities. It also prohibits lifetime monetary caps on insurance coverage, and limits the use of annual caps. It allows small businesses to band together to buy affordable health insurance through state or national exchanges and establishes subsidies, known as premium tax credits and cost-sharing reductions, to help individuals with low incomes afford the marketplace offerings.
The ACA’s most visible changes included:
Providing better value for your health care premium dollar:
The ACA requires that health insurers spend at least 80 percent of the money they collect in premiums on medical costs and quality improvements, instead of on advertising, overhead and bonuses for executives. It has already resulted in billions of dollars in rebates for consumers.
Preventive care: The ACA required insurers to cover a set of recommended preventive services for free, like cancer screenings and diabetes and blood pressure monitoring. 137 million Americans with private insurance now have this benefit, and the ACA has helped reduce the likelihood that adults will skip needed care because of costs.
Young adult coverage:
The ACA lets young adults stay on their parents’ health insurance until age 26, a change that has already helped 5.7 million Americans gain insurance. It has also improved the quality of health care and provided financial security for millions of families.