Let’s set the record straight: In just six years since enactment and three years since the major reforms of the Affordable Care Act went into effect, the law has delivered on the principal goal of covering tens of millions of Americans for whom health insurance was previously out of reach.
Today, twenty million people have health insurance and the percentage of uninsured Americans is at an all-time low. This is a historic and a dramatic improvement over where we were as a nation before the ACA. It could be argued that the period from 2010 to today may be the most successful years in the modern history of U.S. health policy.
{mosads}These accomplishments were achieved despite political opposition aimed at misrepresenting and chipping away at key aspects of the law, and the inherent challenges of launching and stabilizing a new marketplace. As we look to the future of the ACA it is important to see that great opportunities still exist to improve this monumental legislation.
Prior to the Affordable Care Act, the individual marketplace for health insurance was deeply broken. People were sold junk insurance plans at high costs, some individuals with pre-existing conditions were essentially locked out of the marketplace all together, women could be charged more just because of their gender, and plans could drop you the moment you got sick—the time when you need coverage the most.
As a result of the ACA, the marketplace now protects the newly insured and previously insured from the worst abuses of insurers and the standard for what plans must cover is significantly more robust than ever before. Next year, because of built-in protections and thanks to financial assistance and tax credits, the vast majority of consumers will be able to choose a plan for less than $75 per month, even if premiums on every single plan went up dramatically.
Independent experts calculate that marketplace premiums are currently 12 percent to 20 percent lower than the Congressional Budget Office predicted when the ACA was passed and premiums for the 150 million Americans with employer coverage have grown more slowly than before the law was enacted, saving families thousands of dollars.
It is important to recognize that the marketplace created under the Affordable Care Act is in its relative infancy. As with almost every new market—particularly in the health care space—there have been and will continue to be changes and adjustments in these early years. We saw this when Medicare was first created, just as we did with Medicare Advantage and the Part D program—all of which are now popular and mature programs experiencing success.
Recent reports of high premium increases and carriers entering and exiting the exchanges have garnered much attention. We have seen similar headlines in years before, but the reality on the ground has yet to reflect predictions of doom and gloom. In fact, insurers, like the programs themselves, are simply adjusting.
Insurers are entering and exiting the marketplace as they navigate the new landscape of millions of new consumers, protections, and adjust to a new value proposition that favors cost and quality, over finding efficiencies at the detriment of people with preexisting conditions.
The Affordable Care Act is working, but like any law, it is not perfect. It will take a concerted effort on the part of the government agencies, states, and Congress to bring forth solutions that further stabilize the market and separate overblown portrayals that don’t reflect the facts, from meaningful critiques.
2017 is a unique transition year. ACA programs designed to launch the Marketplace off the ground are ending and will have a one-time effect on costs. Yet we will also see the Marketplace risk pool strengthened by robust outreach efforts to young adults not yet taking advantage of the opportunity to get coverage.
The Department of Health and Human Services is also taking steps to strengthen the Marketplace by developing new processes to prevent misuse of Special Enrollment Periods, reduce the prevalence of data-matching issues, and curb the abuse of short term plans that keep healthy consumers out of the risk pool.
Nineteen states also need to do their part to expand Medicaid and thereby increase access to affordable healthcare for 4 million people. A recent report from Health and Human Services showed that expanding Medicaid has enormous economic benefits and on average lowers Marketplace premiums by approximately 7 percent compared to non-expansion states.
The ACA has led to higher consumer satisfaction, lower uninsured rates, and data supports the further stabilization of the Marketplace in the future. It’s now time for Congress to put aside partisanship and finally come together to improve the law. The American people are counting on us.
Rep. Gene Green (D-Texas) is the ranking member of the House Energy and Commerce Health Subcommittee.
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