In 2010, former President Barack Obama introduced the Affordable Care Act (ACA) in an effort to provide more Americans with health coverage. Over the course of its now-nearly eight-year run, the ACA has made significant strides in cutting the number of uninsured in the nation.
Even with the Trump Administration and many Republicans in Congress still seeking to dismantle the ACA, it continues to provide healthcare to those who may not otherwise receive it.
A recent report from the Kaiser Family Foundation (KFF) found that one of the greatest successes of the ACA is filling in the gaps of the “piecemeal insurance system.” While employer-sponsored coverage provides healthcare to the majority of Americans, the ACA’s expansion of Medicaid coverage, the establishment of a Health Insurance Marketplace and healthcare market reform has filled gaps in the health insurance safety net that were previously lacking.
KFF reports that by 2013, the year before the major coverage provisions of the ACA went into effect, more than 44.1 million people lacked coverage. According to the report, poor and low-income adults were particularly likely to lack coverage, with cost the main reason. Since then, 16.5 million Americans, particularly low-income individuals and young adults, have either enrolled in expanded Medicaid or in new coverage options offered by the healthcare marketplace. As a result, the uninsured rate has dropped to a historic low.
States that expanded Medicaid had larger gains in coverage than states that did not, says KFF. Among nonelderly adults, Medicaid expansion states had a 9.2% reduction in uninsured rates between 2013 and 2016 compared to a 4.8% drop in non-expansion states.
And yet, as of 2016, 27.6 million remained without coverage, about 10.3% of nonelderly Americans. Cost continues to prevent some from obtaining healthcare coverage, particularly those individuals who earn too much to be eligible for Medicaid or to receive premium tax credits (PTCs) to offset rising health insurance premiums.
KFF says that nearly 23% of uninsured people are either ineligible due to their immigration status (14%) or because they live in a state that decided not to expand Medicaid (9%). Interestingly, one in four uninsured Americans (14.6 million, or 53%) are not taking advantage of their eligibility to receive financial assistance through either Medicaid or premium tax credits.
With the individual mandate being rendered ineffective starting in 2019 with the passage of recent tax reform legislation, the Congressional Budget Office (CBO) predicts that 13 million more Americans will drop or lose health insurance. The CBO also expects that individual plan premiums will rise 10 percent each year with fewer Americans opting for health insurance coverage.
