Is the ACA Sticking Around Long Term?

Since the Affordable Care Act (ACA) was signed into law in 2010, many government leaders have tried to repeal it. The ACA is still here but how long will it stay in effect?

The most controversial aspects of the ACA, like the individual mandate*, have already been repealed. However, 12 years after its introduction, the law as a whole is very embedded in the American health care system and continues to provide individuals access to affordable health care coverage. The ACA’s longevity presents an excellent opportunity for agents to expand their portfolios with marketplace insurance plans.

*States can still uphold the individual mandate at the state level. California, the District of Columbia, Massachusetts, New Jersey, and Rhode Island still uphold this requirement.

A Brief History

President Barack Obama passed the ACA in 2010 to provide Americans who previously could not afford or qualify for health care with an insurance option. The law was met with opposition from various political parties who feared that the ACA was going to increase health care costs for Americans and was unconstitutional in its coverages. At the time, less than 50 percent of Americans supported the health care bill, as reported by the Kaiser Family Foundation (KFF).

One of the hallmarks of President Donald Trump’s time in office from 2017 to 2021 was his efforts to repeal the ACA in its entirety. To fulfill his campaign promise to retract the ACA, Trump reduced marketing efforts and the number of annual enrollment days from 12 weeks to six weeks, cut subsidies to insurance companies that were offering marketplace coverage, and encouraged more Americans to enroll in coverage through renewable short-term, limited duration health care plans which are not required to meet the 10 essential benefits. These plans are “up to 60 percent cheaper than the least expensive ACA plan” according to the Trump administration in Executive Order 13951. While weakened in power, the ACA survived these actions and repeal attempts.

The most notable of these repeal attempts was California v. Texas in 2021. A group of 20 states, led by Texas, petitioned to eliminate the ACA in its entirety. On the opposite side, 17 states joined California to claim that the ACA was just and provided protections to Americans. The Supreme Court eventually found that none of the states have been harmed by the ACA. A District Court ruled that the individual mandate fine of $0 was unconstitutional, however, the Supreme Court found that “neither the individuals nor the state plaintiffs had ‘standing’ to challenge the mandate or the remainder of the ACA.”

If you’re interested in learning more about the history of the ACA, we provide an overview of the changes that have occurred over the 12 years of the ACA in our article, “The State of the ACA Market in 2022”. At Ritter, we believe these changes have made the ACA market stronger and created an excellent opportunity for insurance agents to reach clients who are under 65 years old and may be looking for affordable health care coverage.

Embedded in the American Health Care System

Because of how embedded the ACA has become in the American health care system, a repeal of the entire law is unlikely, as it could do more harm than good. More than 20 million Americans receive coverage from the ACA, and revoking their coverage at any time would be dangerous to the individual and the health care system.

Considering the status of health care in the United States during the COVID-19 pandemic, if the ACA were to not exist, there would be millions of Americans left uninsured. As reported by the Kaiser Family Foundation, an additional 3.7 million Americans have qualified for marketplace coverage via expanded subsidies. The consequences of that loss of subsidies and coverage would be catastrophic.

Considering the status of health care in the United States during the COVID-19 pandemic, if the ACA were to not exist, there would be millions of Americans left uninsured.

More Bipartisan Support

Many politicians now recognize the value of the ACA and the marketplace. Those who once swore to support the repeal and replacement of the ACA are starting to believe it is integral to the health care system.

For example, Sen. Charles Grassley (R-Iowa) previously held strong opposition to the ACA. Grassley told Iowans in April 2022 that he would not vote to repeal the ACA during a town hall meeting.

Because of this more unified, bipartisan support, Ritter believes that the ACA isn’t going anywhere!

Because of this more unified, bipartisan support, Ritter believes that the ACA isn’t going anywhere!

The Most Controversial Parts of the ACA Have Been Repealed

The most controversial pieces of the ACA — the individual mandate and the associated fine, as well as the Medicaid expansion — have already been repealed.

The individual mandate required that all Americans have health insurance or pay a tax penalty. The tax penalty was lowered to $0 in 2017, effective in 2019. This was one of the most controversial parts of the ACA because many Americans opposed the individual mandate’s role in government supervision of health care, as reported by Dalen, Waterbrook, and Alpert in a study published in the National Library of Medicine.

Additionally, a Medicaid expansion was originally planned to address the coverage gaps and to provide options to healthy, uninsured young adults to keep costs down that were associated with the program. According to the ACA, states that did not expand Medicaid eligibility would lose their Medicaid funding; however, the Supreme Court ruled states could not be coerced to expand their Medicaid offerings. Currently, 39 states have decided to adopt the Medicaid expansion. President Joe Biden recently encouraged states to continue their efforts in expanding their Medicaid programs to cover more adults.

The ACA Going Forward

Instead of repealing the ACA, politicians are more likely to make an effort to improve or modify the ACA as established. Politicians are now focused on maintaining key protections and access to affordable health care such as the 10 core coverages of the ACA.

There have been a few proposals made to improve protections of the ACA. For example, the Biden administration has increased marketing and outreach to reach more individuals who would benefit from ACA coverage. The administration also plans to eliminate the so-called “family glitch” that occurs when those who would be able to purchase subsidized plans through the marketplace cannot because of how eligibility is calculated for those who have access to employer-sponsored family health plans. An estimated 5.1 million people fall into the family glitch and solving it would be monumental for the ACA.

You can review one think-tank’s recommended improvements to be made to the ACA by checking out Exhibit 1 from the Commonwealth Fund’s issue brief on the matter.

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As you can see, all signs point to the ACA being here to stay! Selling marketplace coverage presents an amazing, stable opportunity for independent insurance agents. If you’d like to earn more commissions and help those under 65 who need affordable health care coverage, contact your sales specialist today!

If you’re not already a Ritter agent, register with our site today and check out all of our contract options, tools, and services! We’re here to help you answer questions, provide support, and give you the tools and resources you need to succeed.

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