Protection and Affordable Care Act (PPACA)

The Protection and Affordable Care Act, often referred to as Obamacare or the Affordable Care Act (ACA) is a federal statute enacted by the 111th United States Congress that was signed into law by President Barack Obama on March 23, 2010. This (along with the Health Care and Education Reconciliation Act of 2010) is considered to be the U.S. healthcare system’s most significant and regulatory overhaul and expansion of healthcare coverage since Medicare and Medicaid were passed in 1965.

This import act was passed long after Bill Clinton tried to get a universal health plan passed while he was in office. After Obama’s second term ended, the current administration began making changes to this act and it is likely to change as future administrations come and go. Being informed about this act and how it has changed, and how it may change in the future, is important for anyone who is going to need insurance or medical care at some point if not many, in their lives.

How the ACA Was Originally Played Out
Once the Affordable Care Act was passed, it was not until 2014 that it’s major provisions came into force where people who previously could not afford health insurance and/or who did not qualify for it, had become insured. By 2016, the number of uninsured people in the United States had been reduced by roughly half, with estimates that an additional 20 to 24 million people joined the ranks of the insured by the end of the year.

While many people found the ACA was a much needed blessing that finally allowed them decent healthcare, other people found themselves having to pay more for health insurance, and in extreme cases, individuals who had had adequate health insurance prior to its passing, found they could no longer afford health insurance.

What the ACA Once Looked Like
While this act did not do much to change the existing structure of Medicare, Medicaid, and the employer market, individual markets were radically overhauled. Individual markets are for people who do not qualify for Medicare and Medicaid, and who are not offered health insurance from their employer. Because of the ACA, individual market insurers now had to accept ALL applicants who applied and charged the same rates regardless of preexisting conditions or sex. As a counterbalance to this so that the insurance companies did not suffer severe financial consequences of a unilateral change in the structure of existing healthcare programs, the act mandated that all uninsured individuals had to buy insurance where the insurers would cover a list of essential health benefits.

At the same time as the individual markets changed, there was an expansion of Medicaid eligibility, which is an almost equal reasons for the overall increase in uninsured Americans becoming insured. The changes in Medicaid and individual markets involved new spending that was funded through a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage.

Several Congressional Budget Office reports said that repealing the ACA would increase the deficit and that the law reduced income inequality by taxing primarily the top 1% to fund roughly $600 in benefits on average to families in the bottom 40% of the income distribution. Its reforms were also intended to constrain healthcare costs and improve the quality of healthcare available to all Americans.

After the ACA went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.

Changes in the ACA
The current president was elected promising to repeal the ACA. He issued an executive order on his first day in office to do this.

The Tax Cuts and Jobs Act of 2017 was a repeal that will become effective in 2019 and will make drastic changes in the current structure of the PPACA, and may negatively impact the ability for ALL individuals to be insured.

The PPACA has faced other challenges along the way such as when the Supreme Court ruled 5 to 4 in 2012 that while it would uphold the ACA’s Medicaid expansion as a whole, individual states could choose to not participate in it.

With current changes on the horizon, it is more important than ever to stay informed on what is going on with your healthcare and the law.