Despite fierce attacks, the Affordable Care Act continues to advance Americans’ health care. Millions have gained insurance for the first time and millions more enjoy enhanced coverage with additional consumer protections.
A majority of Americans across party lines agree it is vitally important to maintain key provisions of law such as guaranteed issue and community rating.
Preventing Discrimination Against People With Preexisting Conditions
The Affordable Care Act prohibits insurers from denying coverage to people with preexisting conditions, dropping them when they become sick (called eligibility discrimination) or charging higher premiums than healthy people (“community rating”). Furthermore, it prohibits racial and economic disparities in accessing health care insurance; all provisions have proven immensely popular with the public and attempts at repeal have failed repeatedly.
However, even though it is illegal to discriminate against people with preexisting conditions, evidence shows that many insurers still do so. Economic research indicates that they often change policy terms without prior notice and cause unfair treatment of sick individuals like Jeanne Balvin and Colette Briggs who live with preexisting conditions. AMA pledges its support to make sure patients do not endure this form of backdoor discrimination.
To do this, we will utilize the Affordable Care Act’s nondiscrimination provisions–specifically Sections 1311 and 1557–to protect patients against coverage discrimination. These laws build on Title VI’s civil rights law that prohibits discrimination based on race, color, national origin, sex including pregnancy and age.
Making Health Insurance More Affordable
The Affordable Care Act ensures that health insurance remains both accessible and affordable to millions of Americans without employer-based coverage. It requires all individual and small group health plans to cover certain essential benefits without annual or lifetime limits on coverage, while making sure their premiums reflect actual costs incurred by health care systems.
The Affordable Care Act also made tax credits available to help individuals with moderate incomes afford health insurance, and increased the deduction amount for medical expenses on your taxes, which allows families to avoid financial ruin in case a member becomes sick.
Research has demonstrated that illness no longer spells financial ruin for most American families due to the Affordable Care Act’s consumer protections and affordability measures. Despite attempts by Congress and the Trump administration to dismantle ACA implementation gains, its implementation continues to provide insurance availability and financial security to more American families.
Making Prescription Drugs More Affordable
Affordable prescription drug costs are of primary concern for Americans, and the Affordable Care Act has played an instrumental role in making them more so. Most notably, it mandates insurance companies cover prescription drugs in order to help lower overall costs both for patients and insurers; additionally, rebates were introduced by pharmaceutical manufacturers which increased financial responsibility of these costs while incentivizing more cost-efficient generic versions of medicines.
The Affordable Care Act made accessing care easier by closing Medicare’s “doughnut hole” between 2010 and 2020 – saving seniors thousands annually in out-of-pocket drug costs. Furthermore, private coverage increased for individuals with preexisting conditions as it prevented insurers from denying coverage or charging higher premiums for them.
However, the Affordable Care Act missed opportunities to address drug prices more comprehensively, such as capping out-of-pocket spending on prescriptions and creating an evaluation process to assess both effectiveness and cost-effectiveness for new drugs. Seizing these missed opportunities could help bring down drug prices further while maintaining America’s healthcare system’s affordability for all Americans.
Making Health Care More Accessible
Before the Affordable Care Act was implemented, many Americans could not afford health insurance or its premiums, particularly with high deductibles. Now with financial aid like premium tax credits or cost-sharing reduction subsidies available through this law, Americans have better access to healthcare coverage at more reasonable costs.
The Affordable Care Act also mandates private health plans to cover essential services like cancer screenings, cholesterol tests and annual checkups without charging out-of-pocket costs for them – this ensures no discrimination against certain medical conditions is practiced by insurers while simultaneously giving all Americans access to essential healthcare.
The Affordable Care Act is making strides to address disparities in health coverage and quality, improve outcomes for patients and slow the rate of growth in overall national health expenditure. Unfortunately, however, its gains could be undermined by efforts to repeal or change it and poor administration of its provisions (5)