affordable care act pros and cons

The Affordable Care Act (ACA), also known as Obamacare, has garnered a lot of debate since its implementation in 2010. Although it has created a minimum level of coverage for many insured Americans’ healthcare benefits, it has also created some costly tax penalties for those who don’t participate. Even you may have a pros and cons list from your experience with the Affordable Care Act.

And, as the healthcare reform debate continues, health insurance companies—lacking the information they need to ensure their financial stability—are leaving the ACA’s marketplaces. The companies that are staying in the marketplaces are hiking premiums due to uncertainty around cost-sharing reduction (CSR) subsidies, the loss of which would destabilize the marketplace.

So, in order to weigh both sides of the ongoing debate, we have jotted down a few of the more widespread Affordable Care Act pros and cons.

Affordable Care Act Pros and Cons


The introduction of subsidies
Subsidies make purchasing health insurance less expensive for those who qualify. Also, the implementation of the 80/20 rule means 80 percent of your premium dollars is spent on healthcare instead of administrative costs.

Free preventive care
All qualified health insurance plans must provide 10 essential health benefits, including free preventive and wellness visits. No copay. No deductible. No coinsurance.

No surprise cancellations or pre-existing denials
Insurance companies can’t cancel your policy because of a mistake on an application. Insurance companies also cannot deny coverage for a pre-existing condition (unless your plan is grandfathered).

Medicaid is more inclusive for many
For states that have chosen to expand their program, Medicaid coverage now includes uninsured Americans under 138 percent of the poverty level.

Dependents stay under parents’ plan longer
You can continue to have your children insured under your health plan until they are 26.

No more unreasonable limits
Limits on lifetime benefits have been completely banned and annual limits phased out. (This does not include grandfathered plans).


The cost has not decreased for everyone
Many private plans were canceled because they did not comply with Obamacare. Those affected had to shop for new health insurance and may have ended up paying more for a plan that include benefits, such as maternity care, that they may not need.

Loss of company-sponsored health plans
Some businesses may find it more cost-effective to pay the penalty and let their employees purchase their own insurance on the exchanges rather than provide employer-sponsored coverage.

Tax penalties
If you are uninsured, you may face large tax penalties. You will see the amount when you file your yearly taxes.

Shrinking networks
Many insurance companies made their provider networks smaller in an effort to cut costs while implementing ACA requirements. This left customers with fewer providers that are “in-network.”

Shopping for coverage can be complicated
With the confusion surrounding the rollout of the ACA and the marketplace, limited enrollment periods, difficulties with the websites and more options to choose from, shopping for coverage can be more complicated.

Marketplace uncertainty is raising costs
Health insurance companies are canceling individual plans and hiking premium rates due to the unstable marketplace. Many counties have only one insurance option because of insurance cancelations, decreasing competition, and increasing costs.

Regardless of the Affordable Care Act pros and cons, the professionals at HealthMarkets Insurance Agency can be a helping hand in figuring out your options and getting health insurance quotes for you. Call us today at (800) 304-3414 and let us help you find a plan that meets your needs and budget.


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