How Obamacare Changed the Face of American Health Care
The Affordable Care Act (also known as the ACA or Obamacare) was first enacted in March of 2010, giving millions of uninsured Americans access to medical benefits through Medicaid or the federal Health Insurance Marketplace.
For the millions of Americans who did not qualify for a government- or employer-sponsored insurance, the ACA provided access to online markets where they could purchase private plans. Many lower-income consumers even qualified for government subsidies that reduced their monthly premiums.
However, even in the early days of the law, cracks started to show. Even though Obamacare open enrollment has allowed millions of uninsured Americans to purchase health insurance, not everyone enjoyed the benefits. One notable limitation was that the poorest Americans could not receive premium subsidies, and many also did not qualify for Medicaid in their home states, leaving them uninsured.
Still, by September of 2016, approximately 20 million uninsured adults had obtained affordable Obamacare insurance coverage under the ACA. Along with these changes, the ACA altered the face of American health care in several other important ways. For instance, Obama health care modified important insurance rules pertaining to pre-existing medical conditions, lifetime insurance maximums and women’s health policies.
These changes have made many Americans resistant to Trump health care even as insurance prices continue to soar. Read on to learn how Obamacare has affected health insurance and what could be next for the American health care industry.
The Biggest Changes Under Obamacare
Since Obamacare health insurance first became available, millions of Americans have gained access to medical coverage under Medicaid or private insurance. While consumers must meet strict eligibility requirements in order to qualify for Medicaid, 37 U.S. states including California, Minnesota, Washington, Oregon, New York and Maine have even chosen to expand Medicaid to cover those living in low-income households.
However, in states that did not choose to expand Medicaid, poor Americans are left out of the process entirely. Obamacare was not built to offer subsidies to the poorest Americans and relies instead on individual states expanding their Medicaid offerings to cover these individuals. Poor Americans who live in a state that chose not to expand Medicaid are still finding it hard to purchase insurance.
In addition to the expansion of Medicaid coverage, the Patient Protection and Affordable Care Act changed the face of American health care by:
- Protecting consumers with pre-existing medical conditions. Before Obamacare, insurance companies could deny coverage or charge higher premiums to those with pre-existing health conditions. Under the PPACA, insurers cannot reject consumers or charge them more based on any pre-existing medical condition, including pregnancy, asthma, cancer or diabetes.
- Eliminating yearly and lifetime coverage limits. The Affordable Care Act prevents insurance companies from setting annual and lifetime dollar limits for the amount they spend on essential medical benefits such as prescription drug coverage and inpatient or outpatient care.
- Improving the quality of care that women receive. With free preventive services such as annual mammograms, wellness visits and access to birth control and breastfeeding support, the ACA has arguably provided women with a greater quality of care.
- Setting premiums for health insurance plans, regardless of gender or other factors. Under the ACA, insurers can look at five factors when setting premiums. These factors include the consumer’s age, location and tobacco usage. However, private health insurance companies can no longer take gender or other factors into account when setting the price of premiums.
Has the Affordable Healthcare Act (ACA) increased insurance costs?
Reduced-cost and even free Obamacare plans are available to those who qualify for tax subsidies. To qualify for low-cost Obamacare plans under the ACA, most middle-income families must earn less than $47,520 (for a family of one) and $130,320 (for a family of six). Lower-income households may qualify for cost-sharing reductions and fewer out-of-pocket expenses.
However, while many affordable health insurance options have become available since the enactment of the ACA, the average Obamacare cost has increased by 99 percent since 2013. For families, these averages have increased by 140 percent.
In 2008, for instance, the average health insurance premium was around $159 per individual and $369 per family. By 2013, the average premium ranged from $197 per individual to $426 per family. During the first two months of the 2017 Obamacare enrollment period, these averages jumped to $393 per individual and $1,021 per family.
In addition to these changes in Obamacare costs, the average deductible has also increased significantly since 2008. For instance:
- In 2008, the average deductible per individual was $2,084. Per family, the average deductible was $2,760.
- In 2013, the average insurance deductible per individual was $3,319. Per family, the average deductible was $4,230.
- In 2017, the average insurance deductible rose to $4,328 per individual. Per family, the average deductible jumped to $8,352.
Is Obamacare responsible for these rising health care costs?
Some critics believe that the extraordinary cost increases for health insurance are the direct result of Obamacare, arguing that it could be the result of insuring an additional 20 million consumers, including those with higher medical risks and pre-existing conditions.
Since the ACA requires insurance companies to cover health screenings, immunizations and other preventive services, some experts believe that these factors could have contributed to the rising cost of insurance premiums as well.
On the other hand, the Affordable Care Act may have been responsible for slowing the increase of long- and short-term health insurance expenses. Between 2010 and 2017, for instance, financial reports show that the ACA may have helped to reduce health care spending by $2.3 trillion.
Since the ACA requires insurance companies to cover preventive care services at no additional charge to consumers, doctors are more likely to detect and treat a medical condition in its earlier stages. Through prevention and early detection, patients experience a reduced need for surgery, emergency care and costlier medical treatments.