The Patient Protection and Affordable Care Act, commonly referred to as Obamacare, has allowed millions of Americans to gain health insurance coverage and features several consumer-oriented provisions that improve care quality while simultaneously lowering costs for consumers.
Prior to the Affordable Care Act (ACA), insurers could charge women 1.5 times more for insurance policies, discriminate against people with preexisting conditions, and forgo essential benefits like maternity coverage.
Individuals
The Affordable Care Act made premium tax credits available to help individuals afford private health insurance on the health exchanges, assisting millions of families afford their coverage.
This law required insurers to cover preventive services at no cost for low-income Americans who previously paid out-of-pocket for preventive visits; thus reducing longstanding racial disparities regarding who went to see a doctor when.
The Affordable Care Act programs saved seniors billions on prescription drug costs by lowering payments, and closing the Medicare Part D “donut hole.” In addition, young adults were permitted to remain covered under their parent’s plans until age 26.
Individuals in states that did not expand Medicaid can now receive premium subsidies to assist in affording private health coverage on exchanges, providing much-needed assistance for low-income people as well as those from minority backgrounds. Furthermore, the Affordable Care Act mandates most large employers provide their workers with affordable health benefits or face penalties from law.
Families
Before the Affordable Care Act was passed, women faced numerous barriers to adequate health coverage. Individual market insurers charged women 1.5 times as much for coverage based on gender rating; pregnancy was often treated as preexisting; and plans frequently excluded essential women-centric benefits like birth control and maternity care coverage.
The Affordable Care Act made health insurance more accessible for families by offering financial aid for premiums and cost sharing, and prohibiting insurers from denying coverage based on preexisting conditions. Children can remain on their parent’s plan until age 26 while adults can take advantage of guaranteed issue coverage and financial protections against severe illnesses as well as access to preventive care at no additional cost.
The Affordable Care Act also provided eligibility for Medicaid expansion in states that choose to expand, giving families with low or no cost comprehensive health coverage access to this form of low cost or free coverage. As a result, uninsured rates among working-age women without employer coverage reduced significantly between 2010 and 2016, remaining lower even now than prior to its implementation.
Small Businesses
Small businesses, self-employed individuals and entrepreneurs face unique health coverage challenges when it comes to health coverage. The Affordable Care Act offers new solutions to address them: Small Business Health Options Program (SHOP) marketplaces provide smaller employers with tax credits that help offset insurance costs; moreover, small business owners now have more affordable and comprehensive healthcare through market reforms provided by the ACA that prevent insurers from discriminating based on preexisting conditions or age, eliminate dollar caps on coverage and allow young adults to stay on their parents’ plans until age 26.
In addition to individual marketplaces, the Affordable Care Act created Medicaid expansions and made it easier for people buying on their own to receive subsidies. As a result of these changes, more small-business employees and entrepreneurs now have coverage thanks to the ACA, while many small-business employers who provide coverage have seen premium increases slow. These trends suggest that taking a closer look at healthcare reform marketplaces like HRAs may offer small businesses more effective healthcare delivery systems.
Employers
Millions of patients have benefitted from the Affordable Care Act’s requirement that private health insurers cover preventive services like annual checkups and cancer screenings free of cost to them, helping offset per capita cost growth compared to what would have occurred without it.
The Affordable Care Act prohibits discrimination against preexisting conditions and limits insurers’ ability to charge older consumers higher premiums than younger ones, helping to level the playing field for small employers who struggle to compete with larger firms that can provide workers with comprehensive health coverage at a reduced price. Although these reforms remain significant burdens on small businesses, their offer rates for firms with less than 50 employees appear relatively stable post-ACA.
