The Affordable Care Act (ACA) was enacted in March 2010 by former President Barack Obama. This eventually led to it being dubbed "Obamacare" by some, which is a worthy note to clarify. The ACA and Obamacare are the same piece of legislation.
Years later, in 2023, the Biden-Harris administration saw a record-breaking Open Enrollment Period (OEP), where more than 16.3 million people selected an ACA health plan in the Marketplace. Needless to say, its success, even in the wake of some public criticism, is enduring.
But, what exactly is the ACA, what were the high-level goals that were outlined for the program during its creation, how it is funded and what have been the long-term implications of the act? Here, we'll answer all of those questions and more.
The Affordable Care Act is a landmark health care reform law that was signed more than a decade ago. Through its outlined and high-level primary goals, the Act sought to expand access to health care for millions of Americans through:
These key features of the ACA are in direct response to the highlighted goals of the program. Striving to achieve those goals has greatly contributed to the program's continued success.
Here are those goals:
For context, the three primary goals of the ACA are as follows:
Low-income earners are the main point of focus for the Affordable Care Act; however, the law has defined criteria about who is eligible to benefit from it.
The ACA was specifically designed for families and households that fall under a specific category below certain levels of the FPL. For context, the FPL is a measure of income issued yearly by the Department of Health and Human Services (HHS). It's used to determine someone's eligibility for certain programs and benefits, including the ACA and savings on Marketplace health insurance.
As such, the FPL is updated annually with new numbers and thresholds and is further adjusted based on the size of a family. Here are the most recent FPLs as of 2023:
|Size of Family or Household||Total Household Income|
|Family of 2||$19,720|
|Family of 3||$24,860|
|Family of 4||$30,000|
|Family of 5||$35,140|
|Family of 6||$40,280|
|Family of 7||$45,420|
|Family of 8||$50,560|
Obamacare is paid for via a variety of sources. Most notably, the program is funded as the result of cuts in federal government spending in other areas, increased taxes and penalty payments. Let's look at the sources of income in a little more detail.
While funding for the ACA is acquired via many different means, it's important to note that funding mechanisms are always changing. The Act has undergone many changes throughout its lifetime, wherein different administrations may have modified, delayed or repealed certain funding structures.
The ACA has accomplished a lot of good over the years. In summary, here are a few milestone moments:
In its 12th year (2022), the U.S. Department of Health and Human Services distributed a press release highlighting even more specific accomplishments that the ACA achieved. We'll highlight a few of those wins here, but a complete list of achievements can be found in the press release.
58 million women now benefit from an insurance plan that covers preventive health services, such as:
A pregnancy assistance fund (PAF); Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV); and increased funding for community health centers were also newly introduced.
Older adults and people with disabilities have received extended protection against discrimination by health insurance providers, and essential drugs necessary for their health and well-being have been made more affordable.
The past few years have marked historic gains in health coverage, reducing the number of uninsured Americans by an estimated 20 million. The ACA has also mandated that most insurance companies provide coverage for what the Act calls the 10 essential health benefits:
Millions of dollars have been funneled into many programs that are intent on education and prevention of mental health and substance abuse. Parity protections have also been extended to reduce stigma and provide treatment support and insurance coverage for approximately 30.4 million enrollees.
The health care and insurance landscape is always changing, as is the legislation that surrounds them. As such, it's important that employers stay up-to-date on any revelation, landmark shifts and updates to health care coverage and insurance.
Contact Lewis & Ellis today to speak with a qualified actuary and learn more about how we help organizations understand the current health care landscape and plan for the future.