The History of the ACA and the Effect on Consumers

The History of the ACA and the Effect on Consumers

Affordable Care Act received vast amounts of praise and criticism since its inception in 2010. Policy makers, health insurance providers, brokers have all weighed in and impacted the different iterations of the ACA; however, consumers have felt the effects of all these changes and must stay aware the history of the ACA and how it can affect the future trajectory.

Today, we’ll look back at the history of the ACA in the Supreme Court and analyze past sentiments. The fate of the ACA, and the consumers and businesses effected by it, ultimately lie in the hands of a few key players in politics. Regardless, public opinion and an informed consumer base can sway political opinions have make their voice heard regarding where they want to see the ACA move in the future as recent shifts suggest the ACA is in a prime position to thrive.

Early Iterations of the ACA Brought to Light Issues in the American Health Care System

The Patient Protection and Affordable Care Act is an officially enacted federal statute, executed on March 23, 2010, by then-President Barack Obama. The Affordable Care Act intended to disrupt the health insurance industry in a big way by aiming to reduce skyrocketing healthcare costs for consumers. This includes additional benefits for preventative medicine including routine screenings and annual physician visits. Not only does the shift in focus to preventative care reduce health care costs in the long run, but it also ensures avoidable diseases do not ruin the lives of millions of Americans.

There were significant benefits for the millions of Americans who did not have health insurance coverages or who were underinsured. The ACA also sought to expand Medicaid eligibility, loosening the restrictions and granting those who needed the most help the assistance and programs they needed.

The Health Insurance Marketplace served as the channel with which consumers could directly and efficiently find and enroll in affordable insurance. Removing penalties and denials for pre-existing conditions, the ACA offered solutions to an even broader pool of individuals. And as an additional preventive measure, the ACA required health insurance providers to cover a predetermined roster of essential health benefits.

Despite a Promising Outlook, Consumers Still Faced Challenges in Obtaining Affordable Health Care

Too Little Too Late Regarding Preventative Care

To many critics, the health industry served mostly in a treatment capacity and didn’t focus enough on prevention methods. The ACA defined Essential Health Benefits (EHBs) and imposed requirements on the insurance providers.

Non-grandfathered health plans in the exchanges cover ten specific benefit categories, outlined by CMS:

1. Ambulatory

2. Emergency

3. Hospitalizations

4. Maternity & Newborn Care

5. Mental Health & Substance Use Disorders

6. Prescription Medications

7. Rehabilitative & Habilitative Services

8. Lab Services

9. Preventive Care & General Wellness (Chronic Condition Management Included)

10. Pediatric Services (Vision & Dental Included)

Issues Adapting to a New Way of Health Insurance

Some didn’t like the new law because of its complicated nature. Healthcare isn’t necessarily a cut-and-dry experience. And learning a new way to enroll in health insurance, especially one that required complete faith in the U.S. government, was a tall order for many. Some earlier surveys suggest the two primary reasons Americans refused to participate were a lack of trust in the government and a political opposition to a universal health-type system.

Unanticipated Increased Costs Turned Many Away

Despite the promise of savings across the board, many participants immediately saw much higher premiums. Taxes increased as a direct result of the ACA, and anyone who qualified for ACA coverage but didn’t enroll received fines.

Additionally, companies facing rising benefits costs began reducing employee hours just to avoid the ACA mandates, further punishing the very group of individuals the ACA intended to serve.

The ACA set out to be the magic wand answer to reducing abuse, uncompensated care, and healthcare fraud, as well. On the surface, there didn’t seem to be any immediate disadvantages, making. But with every new policy, comes insights and implementation issues.

Early Rulings in the Supreme Court Sided with the ACA

The ACA sounds great when reviewing the platform’s intentions and individual benefits. But not everyone saw this introduction as a constitutional one. This Democratic Congress initiative faced early objections from Republican lawmakers across the aisle. The challenges continued to mount from Republican governors and running candidates, who joined the nay-sayers and vowed to make every available effort to repeal the ACA in its entirety.

The Supreme Court heard oral arguments back in March of 2012, as opposers alleged such a federally mandated structure would be unconstitutional. By June of 2012, the Supreme Court ruled, by a narrow margin, that the ACA was constitutional. The 2015 case, regarding the expansion of Medicaid, also survived another Supreme Court vote. Despite these early rulings siding with the ACA, future challenges were to come. In 2017, Congress repealed the individual mandate that taxed Americans without insurance. This eliminated a large concern plaguing consumers but open the avenues for future concerns.

Recent Considerations and How the Ruling Impacts Consumers

Despite the repeal of the mandate, the argument was made that entirety of the Act, due to the integral nature of the mandate, is unconstitutional, including the coverage for preexisting conditions. The Supreme Court is considering the ACA yet again, prompted by the Trump Administration along with 18 Republican attorneys general, who sought to strike down the platform claiming it continues to be unconstitutional. The state attorneys general filed the suit in a Texas district court in 2018.

The Biden Administration Breathed New Life into the ACA

The ACA is still officially in place, and millions of Americans, reeling from the pandemic conditions, enroll and find affordable health plans. The Biden Administration took residence in the White House, and a new DOJ statement officially reversed the previous administration’s position. But the Supreme Court still needs to rule on this now named Texas v. California case, challenging the “Individual Shared Responsibility” mandate. Some expect a ruling by July of this year. And while the viability of the entire law is in jeopardy, past rulings might predict continued support and constitutionality of the ACA.

Additionally, the enactment of the American Rescue Act (ARP) brought me legitimacy and needed support to the ACA. Lower premiums and increased availability of tax credits is expected to drive more traffic to the Marketplace.

For additional information regarding how the ARP effects consumers, check out our previous blog below!

 

 

The Future of the ACA

As long as there are opposing views, the Supreme Court will likely continue to hear challenges to the ACA in the coming years. For now, the ecosystem continues to thrive, especially with the increased support and expansion of the platform by President Biden. Despite the recent Republican appointees to the bench, industry experts still predict the ACA will remain intact. And it’s proving to be a viable lifeline for the millions of Americans who desperately need the premium tax credits, preventive care coverages, and marketplace plan options.

Need help understanding where to begin or need to enroll in a Marketplace health insurance plan? Browse with W3ll! Our free service supplies the tools needed to sort and compare health insurance plans to help you get the most out of what the ACA has to offer.

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