The Affordable Care Act (ACA) offers health insurance to millions of individuals. Unfortunately, however, it has encountered various hurdles along its path; such as technical problems with its online federal marketplace platform and short enrollment periods; temporary funding issues related to risk stabilization programs have all presented significant difficulties for implementation of its plans.
The Affordable Care Act’s primary goals include reforming the private insurance market, expanding Medicaid eligibility and altering medical decision making processes. AMA policy supports these goals.
Preexisting conditions
Preexisting conditions have been at the core of much debate about the Affordable Care Act (ACA). These refer to health conditions that exist prior to enrolling for coverage; such as seasonal allergies or cancerous tumors. Estimates place them between 19-50 percent of non-elderly Americans.
The Affordable Care Act has provided protection to people with preexisting conditions from being denied coverage, charged more or subjected to waiting periods. Furthermore, certain limits have been placed on preexisting condition exclusions for small group and individual plans.
Republicans in Congress and state legislatures have proposed bills that would weaken these consumer protections, such as waivers of market reforms such as community rating and essential health benefits, as well as suggestions to decrease or flatten premium subsidies. Yet most polls reveal public support for continuing the ACA’s protections for preexisting conditions; these provisions have wide support among all political factions.
Employer mandate
The Employer Mandate under the Affordable Care Act requires firms with 50 or more full-time employees to provide health insurance that satisfies minimum actuarial value and affordability criteria, placing burdensome costs onto small firms that disproportionately employ low wage workers. Previous studies have demonstrated that mandating employer provision of health care can actually decrease wages for these workers (Klerman and Goldman 1994) thus discouraging firms from hiring more people or decreasing wage rates to comply with this mandate.
The Affordable Care Act’s (ACA) goal is to preserve private insurance options while offering subsidized premiums through exchanges (Werhane and Tieman, 2011). But maintaining coverage on the nongroup market doesn’t necessarily equate with maintaining it – in fact, the reform of this market was always intended to drastically change it due to dysfunctionality, administrative costs and inadequate plans (Werhane and Tieman 2011). Unfortunately due to partisan division over this law it seems unlikely that sensible reforms and modifications will be agreed upon any time soon – hopefully soon enough!
Tax penalties
The Patient Protection and Affordable Care Act (ACA) seeks to bring America closer to universal health coverage by making health insurance more accessible, affordable, and comprehensive. Its regulations include protections for people with preexisting conditions; premium tax credits and cost-sharing subsidies to make nongroup insurance more cost-effective; as well as minimum generosity requirements which ensure minimum generosity in coverage. Its funding comes from multiple sources including an excise tax on high-cost “Cadillac” health plans; fees on medical devices; premiums from uninsured individuals and premiums from individuals remaining uninsured individuals.
Emerging evidence demonstrates that Affordable Care Act provisions are improving access and use of medical care among people enrolled in marketplace-based subsidized insurance and Medicaid expansion states. Unfortunately, however, both Congress and President Trump have made several efforts to repeal or replace it, leaving its future uncertain and further jeopardizing its long-term success. These actions and poor oversight threaten further to derail progress made under ACA while imperiling its future success.
Medicaid expansion
The Affordable Care Act required employers to offer health coverage to employees and established state-based insurance exchanges, expanding Medicaid coverage, prohibiting lifetime monetary caps on insurance policies and permitting young adults under 26 to remain on their parents’ plans until age 26. Though challenging at times, its passage was an impressive political feat.
However, the Affordable Care Act (ACA) has been beset with challenges that have hindered its implementation and may have affected public perception of it. Yet despite all of these setbacks and difficulties, Americans continue to support core ACA provisions like banning insurers from denying coverage of preexisting conditions and expanding Medicaid. Opponents to this law cite either concerns over private insurance being thinned out further or that costs have gone up as a result of this law (KFF 2015c). Expansion of Medicaid expansion remains one of the greatest obstacles to health reform with 19 states refusing participation which risks losing federal funding supplemental payments if this requires expansion goes forward – however.
