By Laurel Duggan
- The Affordable Care Act went into effect 13 years ago, but many of its promises involving health care accessibility and affordability have not been fulfilled.
- Since the legislation went into effect, health insurance premiums and deductibles have skyrocketed, while the country has seen a more modest increase in the proportion of Americans who are insured.
- “The fact that his signature law has failed to deliver on his signature promise, and that health care costs and premiums continue to skyrocket ever higher, demonstrates how Obamacare is truly the Un-Affordable Care Act,” Chris Jacobs, CEO of the Juniper Research Group, told the Daily Caller News Foundation.
Supporters of the Affordable Care Act (ACA), commonly known as Obamacare, made bold claims about the program’s potential to improve American health care costs and accessibility, but 13 years later, the ACA has fallen short on many of those promises.
President Joe Biden celebrated the ACA’s anniversary Thursday with a White House speech touting the program as an “extraordinary achievement.” While more Americans are insured now than prior to the bill’s passage, many of them are insured through Medicaid, and the program doesn’t appear to have made a major dent in mortality.
Former President Barack Obama promised in 2008 that the ACA would reduce the typical family’s health insurance premiums by $2,500 annually. From 2013 to 2019, however, the average monthly premium more than doubled from $244 per month to $558, according to the Heritage Foundation.
A family of four enrolling in a non-subsidized ACA plan can expect to pay $25,000 annually in premiums and deductibles before receiving any benefits.
“The fact that his signature law has failed to deliver on his signature promise, and that health care costs and premiums continue to skyrocket ever higher, demonstrates how Obamacare is truly the Un-Affordable Care Act,” Chris Jacobs, CEO of the Juniper Research Group, told the Daily Caller News Foundation.
Massive Medicaid Expansion
Despite the rising costs of health insurance, significantly more Americans are insured following the passage of Obamacare. The year before the ACA’s passage, 15.4% of Americans were uninsured, according to the Centers for Disease Control and Prevention; that number fell to 8% by 2022.
However, most of those gains in coverage Americans can be attributed to increased Medicaid enrollment, including millions of people who enrolled in the program illegally, according to John Goodman, president of the Goodman Institute for Public Policy Research. This mass enrollment redirects money away from disabled children on state Medicaid waiting lists, and medical establishments often refuse to see Medicaid patients or put them on the bottom of waitlists since Medicaid pays the lowest rates to providers, Goodman wrote for Forbes in April 2022.
“The main aim of the ACA was to get more people insured, and by that measure, it’s certainly succeeded,” Larry Levvit, executive vice president of health policy at the Kaiser Family Foundation, told the DCNF. “The share of people who are uninsured is at its lowest level ever.”
He acknowledged the high cost of ACA coverage, but argued that increased assistance has decreased consumer costs.
“The biggest concern about the ACA from the start was that the insurance coverage was unaffordable. The increased premium assistance now available has brought what people have to pay down by a lot,” he said. “The enhanced premium subsidies were originally part of the American Rescue Plan Act, and then extended through 2025 through the Inflation Reduction Act. A big question mark for the ACA’s success in the future is whether the enhanced premium assistance now available will be made permanent.”
Lower Infant Mortality?
Obamacare supporters went beyond promises of lower costs and greater accessibility by discussing the U.S. infant mortality rate and claiming that thousands of people died each year due to being uninsured, apparently suggesting the ACA would help resolve these issues.
Infant mortality did decline after the ACA went into effect. However, its fall from 6.1 per 1,000 in 2010 to 5.4 per 1,000 in 2020 appears to have continued a trend of modest annual declines that had been underway for decades.
Overall mortality didn’t see major declines under Obamacare either. The age-adjusted annual death rate remained consistent from 2010 to 2018 after decades of gradual decline.
The ACA has faced several legal challenges, the most signifiant of which was National Federation of Independent Business v. Sebelius, which challenged the law’s mandate that everyone who must acquire a certain level of insurance or face a tax. The case led to Congress reducing the tax penalty to zero, effectively ending the individual mandate.
The Trump administration and 18 state attorneys general sued to overturn the Sebelius decision in 2021 on constitutional grounds, but the Supreme Court ruled that the case lacked standing.
“Thirteen years ago, thanks to the leadership of Barack Obama … we made history when the Affordable Care Act became law. And we changed America. We gave millions of people peace of mind,” Biden said in his Thursday speech. “We did something else. We also took a giant step toward realizing the fundamental principle that we hold as Democrats and as Americans: that health care is a right and not a privilege.”
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