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The Affordable Care Act was enacted in March of 2010 and for justifiable reasons. The country was experiencing high uninsured rates, unsustainable spending, and poor health outcomes. Something had to be done. President Obama signed the Affordable Care Act in hopes of reforming both public and private health insurance systems, with a goal to expand coverage to 24 million Americans by the year 2023. Obamacare, nicknamed after its biggest champion, was enacted to increase benefits while lowering costs to consumers. It was also designed to provide new funding toward prevention, reduce inequalities due to income, and improve our overall healthcare infrastructure.

Past Challenges

Despite a number of challenges that included a recession, government shutdown, a problematic website, and lots of partisan politics, the Affordable Care Act still stands. A number of things could have led to its demise, including a newly elected Republican president and Senate in the 2012 election. But probably the most notable threat came as two supreme court challenges, one taking place in 2012 and the other earlier this year, King versus Burwell.  The first case declared elements of the law unconstitutional. The second challenged the interpretation of who is entitled to subsidies, and could have left millions without tax credits.

The Present

Obamacare is achieving many of its goals. It’s reported that by the end of 2014 more than 6.5 million Americans had enrolled in a health plan, and the uninsured rate is the lowest it’s been since 2001. The Affordable Care Act has improved the affordability, availability, and quality of health coverage through regulations, taxes, insurance exchanges, and subsidies. Some of the benefits include things like allowing young adults to stay on parents’ insurance until age 26. It also prevents companies from denying coverage or dropping people when they are sick.  It provides tax breaks for small businesses, while requiring large businesses to insure their employees. And it improves Medicare for seniors.

Our Future

The goals for Obamacare going forward include increasing the threshold for itemized medical expenses on taxes by 2016, requiring health insurance plans to cover preventative care without co-pays by 2018, and phasing out the Medicare coverage gap by 2020. These tasks will not be easy. The Affordable Care Act still faces plenty of uphill battles.

There are at least three major challenges that could derail the law and its future goals. Healthcare costs are still too high, rising faster than wages or overall inflation.  While the ACA includes provisions to lower costs, it may not be enough to offset other trends pushing costs up. If the medical-device tax gets repealed, 3 billion dollars per year contributed to subsidies could be lost. The Cadillac tax, set to take effect in 2018, could force companies to cut back on benefits causing consumers to have more out-of-pocket costs.

Despite all who have taken advantage of Obamacare, anemic enrollment is still a concern. There are still 18 million Americans who are eligible, but haven’t purchased health insurance. The penalty for not having healthcare coverage will increase in 2016, and the rising price of failing to comply may provoke more unrest with the law.

Finally, political resistance is bound to continue with many wondering what might happen if the Republicans capture the White House and Congress in 2016.  Many Republican Presidential front runners have expressed their dislike for the law.

The Affordable Care Act is sure to have more future successes and challenges. Whatever the political outcome is today or in the future, HealthMarkets is proud to be a part of the accomplishment that has resulted in health insurance reaching the uninsured. We will continue to assist customers with their health insurance needs, and look forward to helping you navigate the ever-changing landscape that is the Affordable Care Act.

Learn more about American healthcare history.


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