The Affordable Care Act (ACA), also known as Obamacare, was signed into law in 2010.
The act aimed to provide affordable health insurance coverage for all Americans. The ACA was also designed to protect consumers from insurance company tactics that might drive up patient costs or restrict care.
Millions of Americans have benefitted by receiving insurance coverage through the ACA. Many of these people were unemployed or had low-paying jobs. Some couldn’t work because of a disability or family obligations. Others couldn’t get decent health insurance because of a preexisting medical condition, such as a chronic disease.
The ACA has been highly controversial, despite the positive outcomes.
Conservatives objected to the tax increases and higher insurance premiums needed to pay for Obamacare. Some people in the healthcare industry are critical of the additional workload and costs placed on medical providers. They also think it may have negative effects on the quality of care.
As a result, there are frequent calls for the ACA to be repealed or overhauled.
Here’s a look at some of the pros and cons of Obamacare.
More Americans have health insurance
More than 16 million Americans obtained health insurance coverage within the first five years of the ACA. Young adults make up a large percentage of these newly insured people.
Health insurance is more affordable for many people
Insurance companies must now spend at least 80 percent of insurance premiums on medical care and improvements. The ACA also aims to prevent insurers from making unreasonable rate increases.
Insurance coverage isn’t free by any means, but people now have a wider range of coverage options.
People with preexisting health conditions can no longer be denied coverage
A preexisting condition, such as cancer, made it difficult for many people to get health insurance before the ACA. Most insurance companies wouldn’t cover treatment for these conditions. They said this was because the illness or injury occurred before you were covered by their plans.
Under the ACA, you can’t be denied coverage because of a preexisting health problem.
No time limits exist on care
Before the ACA, some people with chronic health problems ran out of insurance coverage. Insurance companies set limits on the amount of money they would spend on an individual consumer.
Insurance companies can no longer maintain a preset dollar limit on the coverage they provide their customers.
More screenings are covered
The ACA covers many screenings and preventive services. These usually have low copays or deductibles. The hope is that if you’re proactive in your healthcare, you can avoid or delay major health problems later.
Healthier consumers will lead to lower costs over time. For example, a diabetes screening and early treatment may help prevent costly and debilitating treatment later.
“The ACA is going to help all Americans have higher quality and less costly healthcare in the decades to come,” says Dr. Christopher Lillis, an internist in Virginia and a member of Doctors for America.
Prescription drugs cost less
The ACA promised to make prescription drugs more affordable. Many people, particularly senior citizens, are unable to afford all their medications. The number of prescription and generic drugs covered by the ACA is growing every year.
According to a Centers for Medicare and Medicaid Services press release from 2017, Medicare beneficiaries have saved over $26.8 billion on prescription drugs under Obamacare.
Many people have to pay higher premiums
Insurance companies now provide a wider range of benefits and cover people with preexisting conditions. This has caused premiums to rise for a lot of people who already had health insurance.
You can be fined if you don’t have insurance
The goal of Obamacare is for people to be insured year round. If you’re uninsured and don’t obtain an exemption, you must pay a modest fine. Recent events have changed this fine, and beginning with the tax year 2019 it will be eliminated.
Some people think it’s intrusive for the government to require health insurance. ACA supporters argue that not having insurance passes your healthcare costs on to everyone else.
Taxes are going up as a result of the ACA
Several new taxes were passed into law to help pay for the ACA, including taxes on medical device and pharmaceutical sales. Taxes were also increased for people with high incomes. Funding also comes from savings in Medicare payments.
The wealthy are helping to subsidize insurance for the poor. Some economists, however, predict that in the long term, the ACA will help reduce the deficit and may eventually have a positive impact on the budget.
It’s best to be prepared for enrollment day
The ACA website had a lot of technical problems when it was first launched. This made it difficult for people to enroll and led to delays and lower-than-expected signups.
The website problems were eventually fixed, but many consumers have complained that signing up for the right family or business coverage can be tricky. In recent years, the enrollment period has also been shortened to between November 1 and December 15.
Many hospitals and public health agencies have set up programs to help guide consumers and business owners through the setup process. The ACA website also has sections devoted to explaining the procedures and available options.
Businesses are cutting employee hours to avoid covering employees
Opponents of Obamacare claimed the legislation would destroy jobs. The number of full-time jobs has gone up in recent years, but there are still reports of businesses cutting hours from employee schedules.
Business with 50 or more full-time employees must offer insurance or make payments to cover healthcare expenses for employees. By reducing hours, businesses are able to get by the 30-hour-per-week definition of a full-time employee.
The ACA is subject to changes every year. The legislation can be amended, and budget decisions can affect how it’s implemented. Changes in the healthcare field, along with changes to the political makeup of future presidential administrations and Congress, make it likely that the ACA will continue to change for years to come.