Obamacare (or Affordable Care Act), also known as Obamacare, has opened health coverage to millions of Americans – yet many struggle to afford it.
Congress can make several improvements to make the Affordable Care Act truly more cost-effective for everyone. These measures would create more genuinely affordable healthcare coverage.
1. Make it easier to buy health insurance
The Affordable Care Act has helped millions of Americans obtain health coverage and enhance their lives, as well as revolutionized how health care is paid for and delivered across America.
Health insurers charge two types of fees when offering coverage: premium for coverage and deductible for out-of-pocket costs. Premiums can often be adjusted downward to make costs manageable for average people; however, the deductible can sometimes be prohibitively expensive, making using insurance coverage difficult or impossible.
The Affordable Care Act mandates insurance companies provide consumers with rate information in order to facilitate comparison and aid their informed decision-making when choosing to purchase coverage or prevent unnecessary rate hikes.
2. Make it easier for people with pre-existing conditions to get insurance
Access to health insurance can be key in protecting people from preexisting conditions, so the Affordable Care Act prohibits discrimination against such patients.
Under this law, all new health plans must be guaranteed issue plans, meaning they don’t deny coverage based on medical history or charge more to individuals based on these histories. Furthermore, as of 2014 plans must no longer have annual dollar limits on essential benefits.
But even after the Affordable Care Act’s implementation, some people with pre-existing conditions continue to face difficulties getting insurance. Some insurers refuse coverage while other plans charge higher premiums for people who have specific types of pre-existing conditions.
As part of their efforts to address the problem, some state policymakers have created high-risk pools – insurance pools specifically for people who have been rejected from private insurers – as an aid. According to an analysis done under the Affordable Care Act (ACA), such pools could help protect 9 million non-elderly Americans from having their coverage denied because of preexisting conditions.
3. Make it easier for people to get tax credits
The Affordable Care Act includes premium tax credits designed to lower the costs of health insurance for low-income individuals and families. You can use these credits either towards paying your premiums directly, or claim them back when filing your taxes.
The Affordable Care Act expanded eligibility for tax credits to people making 400% or more of the federal poverty level, enabling some individuals to pay less than 8.5% of their household income towards Marketplace premiums.
Without these expanded tax credits, premiums for high-income individuals would nearly double. This would likely have led to more consumers leaving the individual market and thus increasing health insurance premiums across the board.
The Affordable Care Act also broadened eligibility for premium subsidies among lawfully present immigrants who have lived in the US for at least five years – even those not eligible for Medicaid may receive premium assistance through health insurance exchanges.
4. Make it easier for employers to offer health insurance
Health insurance is one of the most appealing benefits an employer can provide to employees, yet it can be challenging deciding whether or not to offer such plans.
Employers may find it beneficial to make it simpler for their employees to obtain health insurance, including making selecting an employee-focused plan easier as well as offering small group options and individual plans through exchanges.
Selecting an insurance plan requires considerable research on behalf of an employer. It involves deciding how much to spend on premiums and related costs, as well as understanding all available coverage.
HMOs and PPOs tend to be cheaper due to having smaller networks of providers; however, these plans typically have higher deductibles and copays. Furthermore, referrals may be required for specialist care; making them less appealing options for some employees.