The Affordable Care Act, or ACA, was an historic piece of legislation intended to transform the health insurance market, make health coverage more cost-effective, and decrease healthcare expenditures.
However, some of its promises were broken; many Americans are still not getting access to adequate health care coverage.
1. It was too important to compromise
The Affordable Care Act is an intricacie law and its implementation necessitates careful efforts at building political support, clarifying public confusion about its effects, and persuading reluctant or hostile state policymakers to collaborate in its implementation project. Furthermore, its implementation necessitates balancing competing demands on its resources.
Due to this dynamic, the Affordable Care Act has fallen far short of its coverage goals. Millions of eligible persons who could qualify for subsidised health coverage have not obtained it and focus group research indicates they view these plans as too expensive (Blumberg and Holahan 2015).
The Affordable Care Act’s Reinsurance Program and 80/20 Rule were intended to help lower premium costs, with insurers spending at least 80 percent of premium dollars on medical care and quality improvements rather than advertising, overhead costs or bonuses for executives. Unfortunately, partisan politics have undermined these efforts to implement the Act effectively.
2. It was too expensive
The Affordable Care Act (ACA) mandates most employers provide their workers with health coverage, establishes state or multistate-based insurance exchanges where individuals and small businesses can purchase coverage, and expands Medicaid coverage up to 133% of federal poverty level. Furthermore, lifetime monetary caps on coverage have been banned as have limits placed upon insurers to cancel or resccind policies.
Though the law has its shortcomings, it has had a notable impact on decreasing uninsured Americans in New York State; however, Covid-19’s pandemic has brought to light continuing issues that need addressing.
The Affordable Care Act was never meant to solve every problem, and its architects recognize its flaws. Notably, its architects acknowledge that its implementation left several gaps; for instance, not enough has been done to control health care prices which remain too expensive for most people – as documented by Gothamist and WNYC’s crowdsourced health cost project PriceCheckNYC, many live in fear that medical care will drain savings funds just to see a doctor.
3. It was too complicated
Republican control of Congress and the White House was initially promised as a promise of dismantling Obamacare; yet, in spite of their efforts, most aspects of it remain in place today. Due to its coverage expansion and consumer protections, millions more people now participate in health insurance markets while being protected against preexisting condition discrimination.
One of the goals of the Affordable Care Act (ACA) was to ensure marketplace enrollees had affordable health coverage options by mandating that insurers offer qualifying health plans (QHPs) at rates no greater than expected medical spending for costlier enrollees. To do this, large numbers of young and healthy individuals needed to purchase QHPs; unfortunately due to failure by this group to do so has led insurance companies incurring substantial losses and leading them away from exchanges altogether.
The Trump administration tried to solve these problems by increasing access to cheaper, lower-quality coverage through expanded employer association health plans and short-term limited duration plans; but their presence caused market instability that undermined coverage and drove down enrollment numbers.
4. It didn’t work
Proponents of the Affordable Care Act promised it would reduce healthcare costs and give patients more options; in reality, however, costs have skyrocketed while patient choices have drastically diminished.
One reason for this trend may be Obamacare’s ban on insurers using health status when setting premiums, forcing them to overcharge younger and healthier enrollees while undercharging older and sicker ones relative to expected healthcare spending.
Additionally, expensive new mandates and restrictions on insurance providers and companies have contributed to increased premiums. This includes community rating restrictions on premiums as well as essential benefits mandates that must be included within coverage agreements.
Add this to the fact that many insurers are experiencing financial strain and the result has been double-digit premium increases – it is no wonder people have no intention of signing up!
