Pros And Cons Of The Affordable Care Act

The Affordable Care Act, also known as ACA and ObamaCare, was signed into law by

President Obama on March 23, 2010. Since its implementation, the ACA has greatly improved

the American health care system by reforming "health insurance, health care costs, and the

delivery of care" (French et al.). But its main purpose was to reduce the number of uninsured

Americans who were poor and could not afford private health insurance, and people with pre-

existing conditions who were denied health insurance. The provisions that have had the most

impact are the Medicaid expansion, subsidies, dependent coverage, and guaranteed insurance for

high-risk people. As of 2015, 30 million people had insurance under these four provisions

(Blumenthal

The ACA established laws that fixed many problems that indirectly harmed low-income

people who had high cost medical conditions. One of the laws in the ACA limited out-of-pocket

costs on in-network cost sharing. Out-of-pocket costs is the amount of money not covered by

insurance that someone has to pay themselves and includes copayments, coinsurance, and

deductibles. In-network cost sharing is a copayment that the insurer and the insuree share when

the insuree receives care from the insurer's network of hospitals and doctors. This law limits the

amount of money someone pays out-of-pocket annually for medical bills. Currently, the

maximum out-of-pocket costs for an individual is $5,950 and $11,900 for a family (KFF

"Actuarial Values" 2). []Low-income people would suffer the most without this law, as they

would be unable to afford frequent medical bills, and as a result their health would suffer.

Another law in the ACA that helps low-income people pay medical bills is the

The higher someone's value, the less they have to pay for bills.

For instance, if someone's actuarial value is 60%, the insurer pays 60% of the medical bill and

the insuree pays 40%.

Medicaid is a U.S. health care program that provides free or low-cost health insurance to

people who have low incomes. In 2014 Medicaid was expanded to cover people whose income

did not exceed 138% of the federal poverty level (Stoltzfus and Pollack). However, states had the

option to not expand their Medicaid system. Currently , 31 states have expanded their

Medicaid system and 19 have not (KFF "Medicaid Expansion"). The expansion extended

Medicaid's coverage to the 'coverage gap'. The coverage gap included the people who were too

rich for Medicaid, but too poor to afford private insurance. About 3.7 million adults are in the

coverage gap in the states who chose not to expand their Medicaid system (Artiga et al.). These

low-income adults in the coverage gap are usually uninsured and are paying their medical

expenses out-of-pocket. However, people in expansion states have benefited tremendously from

their new coverage. []Medicaid expansion states have seen an increase in diabetes diagnoses