The Pros and Cons of the Affordable Care Act

affordable care act pros and cons

The Affordable Care Act or ACA was signed into law in 2010 to provide affordable health insurance coverage for all Americans. This act also saved and protected consumers from health insurance company tricks that may increase healthcare coverage costs or restrict their care. Millions of people in America have benefited from the ACA, as due to this act they were able to receive health insurance coverage. Many among these were either unemployed people or who had low-paying jobs. Some of the people were unable to have health insurance before ACA because either due to disability or they were suffering from a preexisting medical condition. Despite several benefits, this act has been controversial. The conservatives opposed this Act because of the tax increase and higher premiums of the ACA plans. Even employees of the healthcare industry were not happy with the Act because of the additional workload placed and the cost incurred on them, and they also thought that this Act may have negative effects on the quality of healthcare. For all these reasons there are calls to repeal or overhaul the Affordable Care Act.

Pros of the Affordable Care Act

More People have Health Insurance Coverage after ACA

Within the first five years of the Affordable Care Act, more than 16 million people obtained health insurance coverage in America, most of which included young adults. However, overall enrollment in ACA plans steadily decreased after that but in the last two years, the enrollment in the ACA plans has remained steady at about 11.4 million people.

Preventive Care Benefits

All qualified ACA health insurance plans need to provide ten essential health benefits such as preventive care and wellness visits with no copay, deductible, or coinsurance included in the plan. The ACA plans covered many preventive services, and so enrollees who were proactive in their healthcare were able to avoid or delay major health issues later on. This eventually leads to lower costs over time, as an early diagnosis and treatment of a medical issue like diabetes may help prevent expensive and debilitating treatment later on.

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Health Insurance became Affordable for Many

The Affordable Care Act required health insurance companies to spend at least 80 percent of insurance premiums on medical care and improvements. Besides this Act also prevented health insurance companies from making unreasonable increases in the prices. Though health insurance coverage is not free, but after this Act people had a wider range of coverage options.

Coverage for pre-existing Health Conditions

The Affordable Care Act prevented individuals having pre-existing health conditions to be denied health coverage. Prior to the Affordable Care Act, a pre-existing medical condition like cancer made it extremely difficult for the patients to obtain health coverage, as most of the health insurance companies denied providing coverage for the treatment of these conditions. The carriers believed that the injury or illness occurred before they were covered under their plan, so they were not ready to cover those conditions. However, under the Affordable Care Act, no one can be denied coverage because of a pre-existing health problem.

No preset dollar limit on the coverage

Before the Affordable Care Act, health insurance companies used to set a specific limit on the amount they would spend on the treatment of an individual consumer, so some people with major health issues ran out of insurance coverage. However, after the implementation of the Affordable Care Act, health insurance companies can no longer keep a preset dollar limit on the coverage offered to customers.

Dependents can stay under their Parents’ plan for a Longer Duration

Children until the age of 26 years can remain insured under their parent’s plan. The inclusion of children in their parent’s plan allows health insurance companies to have more profits, as they received more premiums by offering coverage to these healthy individuals.

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Provides Coverage for Ten Essential Health Benefits

All ACA health insurance plans are required to cover ten essential health benefits including treatment for mental health, addiction, and chronic diseases. Without essential health benefits, many patients may land up in the emergency room.

More screenings are covered

The ACA plan provides coverage for many screenings and usually have low copays or deductibles. This is done with the aim that people remain conscious of their health and immediately visit a doctor for any health issue and avail themselves the proper treatment at the beginning of a health problem before it becomes a major health problem later.

Prescription drugs cost less

The ACA has made all efforts to make prescription drugs more affordable for all, especially the senior citizens, who are unable to afford their medications. The ACA covered prescription and generic drugs numbers are growing every year. Even Medicare beneficiaries have saved on prescription drugs under Obamacare.

Cons of the Affordable Care Act

Many people have to pay higher premiums

With insurance companies requiring to provide a wider range of benefits to enrollees and they also need to provide coverage to people with preexisting conditions, so they have to increase the monthly premium for people who already had health insurance.

In some States, people can be fined for not having insurance

The main objective of Obamacare is to keep people insured all through the year. In some of the states if people remain uninsured and they don’t obtain an exemption, then they need to pay a modest fine. Nevertheless, this penalty has been repealed from most of the states, beginning with the tax year 2019. However, people favoring the ACA argue that by not having health insurance people pass their healthcare costs on to everyone.

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Taxes are rising because of the ACA

With the coming of the Affordable Care Act, the government has imposed several new taxes like taxes on medical devices and pharmaceutical sales. To obtain financial support for the ACA, people also raise taxes for people with high incomes. The intention behind it is to seek wealthy help to subsidize health insurance for the poor.

Short Enrollment Period

The enrollment period between November 1 and December 15 is often considered as not long enough, and many people fail to enroll during this period, either due to website technical problems or due to tricky health insurance options.

Network Providers are Shrinking

To implement ACA requirements most of the health insurance companies are cutting costs by shrinking their provider networks. This leaves health insurance consumers with fewer providers that are in-network.

Cancellation of Many Plans

Most of the health plans offered by the private health insurance companies got canceled because the policies didn’t cover the ACA’s ten essential benefits. As a result, millions of people who relied on private health insurance lost coverage. The costs of replacing those plans were extremely high so many people became uninsured.

Loss of Employer-sponsored plans

As many businesses found paying penalties more cost-effective, they allowed their employees to purchase health insurance from the exchange, so nearly three to five million people lost their employer-sponsored health insurance.

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