Affordable Care Act Pros and Cons: Will It Last?

The Affordable Care Act was signed into law over a decade ago with the purpose of making affordable, high-quality health insurance available to everyone regardless of employment status or income. It also put new protections into place for consumers to help prevent high health care costs or denied coverage.

As a result of the ACA, many who had not been able to get health insurance due to limited means or pre-existing conditions could obtain coverage. While a lot of good has come from the law, there have been serious downsides as well, leaving many to wonder whether the ACA will stand the test of time or be repealed and replaced.

The Benefits of the ACA

More Accessible Coverage

Within the first five years after the ACA was signed into law, more than 16 million Americans were able to sign up for health insurance. The majority of the newly insured were young adults.

More Affordable Coverage

Those that qualify/qualified for a “Subsidy” where the Government helps pay for your health plans, this made the premiums more affordable. Under the ACA, health insurance companies must spend at least 80% of policyholders’ premiums on medical care. Only 20% of the money they take in can go towards marketing, overhead and administrative costs. This is called the “Medical Loss Ratio”. If the health insurance company does not meet the 80/20 target, it is required to pay back the money from premiums back to the policyholders.

Coverage for Pre-Existing Conditions

Prior to the ACA, health insurance companies could deny coverage for pre-existing conditions such as cancer, or birth defects and many other medical conditions. Even if you had very common health conditions like diabetes, they could deny coverage entirely, or some companies would deny coverage for pre-existing conditions up to a time frame, like 1 or 2 years. That depended on the plan.

Coverage for Maternity and Mental Health

Prior to the ACA, major medical plans would most likely not cover maternity, at all, and most plans had no coverage for mental health, but it depended on the plan. There was no coverage for these medical needs.​

The Drawbacks of the ACA

Cutting Workers Hours

Businesses are cutting hours to avoid providing health insurance benefits. The ACA penalized larger businesses that did not provide health benefits to full time employees. Reacting to this law, many workers lost their employer health insurance because, rather than providing benefits, businesses found it was cheaper to reduce employees’ hours to part time or just pay the penalty. The penalty mathematically is much cheaper than providing benefits, so this was an unfortunate side effect.

Health Care Costs Went Up

Even though the plan is the “Affordable Care Act”, health insurance plans doubled and even tripled in some cases. All pre-existing conditions without limits had to be covered, all 10 “essential healthcare benefits” must be covered without limits, along with Maternity and Mental Health and other coverages too, including free wellness coverage. All these added up to be much more expensive. Because health insurance companies must now pay for these additional services, cover all pre-existing conditions, and must now have out-of-pocket maximums on all plans, this increased the premiums significantly.

Taxes Went Up

Several new tax laws were passed to pay for the ACA, including taxes on pharmaceutical sales and medical devices.

What to Expect in the Future

As it is, the ACA undergoes scrutiny and is subject to changes all the time, and each new administration likes to get in their own changes. The general public is somewhat divided on whether the ACA has caused more harm than good, and the current and future presidential administrations are likely to continue making changes. Most of the ACA’s critics are not interested in seeing the law repealed, they simply want to address its problems. Ultimately, it is unlikely that we will see the ACA repealed and replaced anytime soon.

Finding the Best Health Insurance with Nevada Insurance Enrollment

While the ACA is far from perfect, it has made health insurance accessible to many. At Nevada Insurance Enrollment, our health insurance agents can determine whether you qualify for a subsidy to bring down or eliminate your monthly premium. We help you compare plans across multiple health insurance providers to find the right one for your needs.