What’s next for the Affordable Care Act

Five years ago, the Patient Protection and Affordable Care Act (ACA) became law. It is a landmark legislative achievement that brought us many steps closer to realizing a long-held principle: Access to healthcare is not a privilege, but a right. Health insurance means security; to paraphrase President Harry Truman, it means protection against the economic effects of sickness. I strongly supported the ACA when it was passed in 2010 and continue to support it today.

The ACA has successfully increased access to affordable, quality health insurance for millions of Americans, many who gained coverage for the first time in their lives. Over 16.4 million formerly uninsured Americans now have affordable healthcare. The White House estimates that 129 million Americans who could have been denied coverage prior to the ACA’s passage are now covered. Our country now holds the lowest rate of uninsured Americans in its history. 

{mosads}The ACA’s most visible success has been to increase the number of Americans with health insurance coverage, but at the five-year mark, we note not only the transformation in coverage, but also the decline in hospital readmission rates, improvement in hospital-acquired infection rates and the bolstering of primary care capacity.

Growth in healthcare spending has slowed to the lowest rate in 50 years. Bending this curve is critical to shoring up the long-term sustainability of our healthcare system. The Congressional Budget Office (CBO) now projects that federal health spending will be nearly $700 billion less over the 2011-2020 period than the CBO projected in January 2010.

In short, access to affordable insurance is up, the uninsured rate is down, spending growth rates are leveling off and the quality of care continues to improve. It is clear that the ACA is working.

Despite some of the rhetoric around healthcare, it is important to remember that the individual insurance market was deeply broken prior to the ACA. Insurance companies could deny coverage or charge unreasonable amounts to consumers because they had pre-existing conditions. Insurers could put annual and lifetime caps on how much care they would pay for.

Through the ACA’s reforms, millions gained access to health insurance that will actually be there when they need it, protecting patients and their families from financial ruin if they get sick. Insurers can no longer discriminate against pre-existing conditions, charge women more just for being women or put caps on the care they will pay for. Consumers receive more value for their premium dollars because insurance companies are required to spend between 80 percent and 85 percent of premiums on medical care, rather than on administrative costs.

The recent Supreme Court decision in King v. Burwell confirms that subsidies provided under the law were meant for consumers in all states. This is far from surprising, because a driving belief at the center of the ACA is that people should have access to affordable, quality coverage regardless of socioeconomic status, gender, age, health status or the state in which they live.

After the Supreme Court recently upheld yet another provision of the ACA, it is time for opponents of healthcare reform to accept that the ACA is here to stay and stop partisan attempts to block, repeal or undermine key elements of the successful law.

States should take steps to more fully implement the Affordable Care Act. The states that have adopted Medicaid expansion have seen larger gains in coverage than non-expansion states and generally are saving money in their budgets. Recent reports confirm that hospitals in these states are treating fewer uninsured patients and experiencing steep declines in the amount of uncompensated care they are providing. Furthermore, contrary to claims that Medicaid expansion is financially unsustainable for states, there is a growing body of evidence that expansion has saved states money and that these savings are expected to grow over time. Policymakers in the states that have not expanded Medicaid should now do so. This will enable an estimated 3.7 million uninsured Americans with low incomes to finally secure access to affordable health coverage.

It is true that the ACA continues to have a positive impact on the American people and our health system at large. However, no law is perfect. It is long past time for us to come together to constructively build on the ACA’s successes and improve the law. We must keep working to make healthcare in America even better and more affordable and get more people covered.