When President Barack Obama debuted the Affordable Care Act in 2010, it was met with conflicting waves of approval and derision. Some welcomed the ACA as a step towards the modernization of the healthcare system in the only first world country on the planet that doesn't guarantee healthcare as a right to its residents. Others balked, saying the ACA either went too far or didn't go far enough towards this end. In particular, critics cited the "individual mandate" which stated that every American must acquire some kind of healthcare coverage or suffer monetary penalties at tax time. Those critics inside and outside the government disparaged the ACA as a disaster and necessary to repeal. This desire to repeal the ACA came to a head in 2013 when members of Congress actively shut down the government over the ACA.
In the 2016 Presidential election, the potential repeal of the ACA became a major talking point. As the new Presidential administration under Donald Trump came to power in 2017, talks of immediate repeal and replace of the ACA ran rampant in Washington. The ACA's civilian proponents flooded townhalls to protest. Ultimately, in a dramatic showdown on Capitol Hill, the vote to strike down the ACA was itself defeated in a climatic decisive vote by the late Senator John McCain. Since then, critics of the ACA inside the government has still shown a desire to end the controversial healthcare bill, claiming it a disease on the American economy. How true that is, however, may be in doubt.
Following two years of premium increases of roughly 30% each, this year is projected to
stabilize at 3.6% according to a study by Avalere Health in conjunction with the Associated Press. Premiums under the ACA system are projected to either increase incrementally or decrease in most states. The study also claims that the exodus of insurers from the system seems to be reversing as some seem willing to enter back into the system. Currently,
no counties in the country are lacking for a insurer, a major point of contention for critics of the ACA who say that the act drove insurance companies away from various parts of the country.
Currently, 11.8 million Americans opted in or were re-enrolled into the ACA system, which is a slight decrease from the previous year's 12.2 million. Of those numbers, 3 million Americans signed up through state sponsored websites such as the Golden State's
Covered California site while the remaining 8.8 million signed up through the federal ACA website. Of those enrolled into the system, about 27% were new customers while 63% purchased the silver plan, the middle option.
This is not to say that the ACA is without faults. As it stands right now, the cost of an average healthcare plan's monthly premium runs about $621 under the ACA, far above what most consumers would consider to be affordable. Some of these costs are being offset by subsidies and tax credits but the practice may not be a sustainable relief valve for the costs, putting the ACA less as a viable market and more as a public safety net that isn't so comprehensive for Americans. On top of this, many of the enrolled members are forced to pick plans with high annual deductibles in the ballpark of $6,000 in order to afford monthly payments, putting the question out of how insured members really are.
Part of the issue is that the individual mandate (put in place to guarantee financial solvency for the whole system) didn't create as strong an incentive as the Obama Administration had hoped with many younger, healthier Americans opting to just pay the tax fine instead. At the end of 2017, the GOP tax cuts effectively neutered the mandate, putting the entire system's solvency in doubt. However, another change to the system,
eliminating cost sharing reductions pushed insurers to exploit a loophole in the ACA that led to a boost in the subsidies provided. If the purpose was to undercut the ACA, it backfired.
As the midterm elections come over the horizon, the ACA-- or "Obamacare" as its critics would often derisively call it-- is no longer a hot potato for politicians. Several Democratic candidates
have embraced stories of the ACA helping the previously uninsured get treatment. Conversely, many Democrats are now touting a Medicare for All solution,
including President Obama himself. It remains to be seen how this will effect the future of the Affordable Care Act.