The Affordable Care Act ensures you get value for every premium dollar by mandating that insurance companies devote at least 80% of premium dollars towards medical care and quality improvements. Furthermore, competition and more expeditious Food and Drug Administration approval of biologic drugs is encouraged, making them more cost-effective.
1. More People Have Coverage
The Affordable Care Act enabled individuals without employer health benefits to purchase comprehensive coverage on their own. It established health insurance marketplaces where people could shop and purchase plans with financial aid available to help pay premiums and reduce cost sharing. Furthermore, lifetime and annual benefit limits and rescissions were prohibited and all individual and small group plans had to provide an essential health benefits package.
The Affordable Care Act also helps slow health care cost growth, making hiring employees more affordable for businesses and increasing economic opportunity. Furthermore, lower health care costs mean consumers will have more disposable income to spend on other goods and services.
2. More People Are Covered
The Affordable Care Act’s health insurance marketplaces made private coverage more affordable for many Americans, with federal financial assistance making premium payments more manageable for many enrollees – in 2019, almost nine out of 10 marketplace enrollees received assistance for their plan!
Uninsured rates decreased for all households, particularly lower-income ones and those who did not have access to employment-based group health plans. It also fell across racial/ethnic groups and educational levels.
These gains stem from the Affordable Care Act’s prohibition against discrimination against preexisting conditions, its reforms to individual and small group health insurance markets, as well as consumer protections such as easy-to-read summaries of benefits and coverage.
3. More People Are Covered for Pre-Existing Conditions
Before the Affordable Care Act was implemented, many individuals in the individual market were denied coverage or charged higher premiums due to preexisting conditions. Thanks to ACA reforms, such discriminatory practices are no longer legal on either market; subsidies make purchasing affordable private health insurance easier for many Americans; recommended preventive services must now be covered without copays or deductibles; rebates will also be returned when insurers overcharge consumers via medical loss ratio rules.
The Affordable Care Act also eliminated annual and lifetime limits, which prevented some sicker patients from accessing essential medical care or protecting themselves against financially catastrophic medical events.
4. More People Are Covered for Preventive Care
ACA requires health plans to cover preventive services without charging you a copay or deductible, including many important and lifesaving screenings such as Hepatitis C screening, Colorectal cancer screening and Breast cancer screening.
Many of the 137 million Americans with private health insurance rely on it, while millions of young adults covered under their parents’ plan have taken advantage of being allowed to remain until age 26.
The Affordable Care Act’s emphasis on prevention is helping transform our health care system from treating disease into one that promotes overall wellness and keeps patients out of hospitals.
5. More People Are Covered for Mental Health Care
Historically, those living with mental health conditions were twice as likely to be uninsured and faced significant barriers in accessing care. Thankfully, the Affordable Care Act made significant strides forward by mandating that all individual and small-group plans cover essential benefits including behavioral health services; additionally it requires coverage parity among large group plans.
GAO reviews indicate that consumers with behavioral health needs encounter access issues, such as difficulty finding in-network providers or lacking affordable options. Federal efforts are underway to address these concerns by expanding provider networks and offering competitive reimbursement rates.
6. More People Are Covered for Prescription Drugs
As new drug approvals and therapeutic advances expand, more Americans may soon discover that some novel medicines carry high price tags. To protect payers and encourage use of lower-cost drugs, the Affordable Care Act includes protections like rebates that benefit payers as well as closing the Medicare “donut hole” as well as capping prices on the most costly meds.
The Affordable Care Act ensures you get maximum value from your premium dollars, by mandating that private health insurers spend 80 percent or more of premium dollars directly on medical care and quality improvement, or provide rebates directly back to consumers. In addition, all plans must include essential benefits like mental health and substance abuse treatment as mandated by law. Learn more.
