Analysis Examines the Affordable Care Act's Impact on Nearly All
Americans
A week after the 2020 elections,
the Supreme Court is scheduled to hear arguments on a legal challenge,
supported by the Trump administration, that seeks to overturn the Affordable
Care Act (ACA), an outcome that would have major effects throughout the
health care system as the law’s provisions have affected nearly all Americans
in some way.
A KFF analysis examines key provisions of the 2010 law
that have changed the nation’s health care system, including what’s known
about their impact on people’s access to affordable care and coverage,
including state-by-state data where available. Key impacts include:
- About 12 million Medicaid enrollees in 33
states and D.C. became newly eligible for the program through Medicaid
expansion, as of June 2019. This includes 3.7 million in California and
at least half of a million each in Pennsylvania, Michigan, Illinois,
Washington, Ohio and New Jersey.
- As of February, 10.7 million people were
enrolled in coverage through the health insurance marketplaces created
under the ACA, including 9.2 million who received premium tax credits
and 5.3 million who got cost-sharing reductions. In Florida, Mississippi,
Alabama, Nebraska and Oklahoma, at least 95% of marketplace enrollees
receive premium tax credits and/or cost-sharing subsidies.
- Insurers can no
longer deny coverage for pre-existing conditions, charge higher premiums
based on health status or gender, revoke coverage when someone gets sick
or impose annual or lifetime limits. About 54 million people have a
pre-existing condition that could have resulted in them being denied
coverage in the pre-ACA individual market. This includes more than a third
of residents in Alabama, Arkansas, Kentucky, Louisiana, Mississippi and
West Virginia.
- Private insurers
now must cover a wide range of preventive services at no out-of-pocket
costs to consumers. This includes recommended cancer and chronic
condition screenings, immunizations, and other services. Nearly 150
million people are enrolled in employer plans or through individual
market insurance that must provide these free preventive services.
- The law phased
out the Medicare coverage gap, often called the “doughnut hole” by
gradually reducing the share of total drug costs paid by Part D enrollees
in the coverage gap. About 46 million Medicare beneficiaries are
enrolled in Part D drug plans.
- About 2.3 million young adults gained coverage
due to the ACA’s provision allowing adult children to remain on their
parents’ insurance plan up to age 26.
The analysis is part of KFF’s ongoing efforts to provide
useful information related to the health policy issues relevant for the 2020
elections, including policy analysis, polling, and journalism. Find more on
our Election 2020 resource page.
Filling
the need for trusted information on national health issues, KFF (Kaiser Family Foundation)
is a nonprofit organization based in San Francisco, California.
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