What’s happened during the past six years of the Affordable Care Act?
By Roberta Riportella, Kansas Health Foundation professor of community health at Kansas State University and K-State Research and Extension
Released: March 29, 2016
MANHATTAN, Kan. – In 2016, we recognize more than 100 years of health care progress in the United States. President Teddy Roosevelt first proposed a national health insurance program in 1912. The Affordable Care Act, also known at Obamacare, turned 6 years old on March 23, 2016, and its elder sibling, Medicare, turns 51 in a few months.
In terms of significance, the passage of the ACA in 2010 is often compared to the establishment of Medicare and Medicaid in 1965. Both programs continue to evolve and provide access to health care for millions of Americans.
While political discussions about the best way to expand access to health care remain, 20 million uninsured adults ages 18 to 64 have gained health insurance coverage since the ACA took effect. The number of children insured has also increased, since many children whose parents are signing up for health insurance have been found eligible for already existing Medicaid programs.
The uninsured rate has decreased substantially across all races and ethnicities throughout the country. Some of these numbers include those who have gained insurance through Medicaid expansion that has occurred in 31 states and the District of Columbia. Without a Medicaid expansion in Kansas, however, approximately 127,000 Kansans who could be eligible for that program remain uninsured, according to the Kansas Health Institute.
In Kansas, 100,500 people signed up for health insurance through HealthCare.gov during the recent open enrollment period that ended Jan. 31. At least 80 percent of those who enrolled qualified for assistance in paying premiums. Many more have also been impacted by what are considered the consumer protections of the ACA that affect all insurance plans, including employer-sponsored and other private plans. These features include:
- Young adults can stay on a parent plan until age 26.
- Insurance companies have to take all applicants; that is, no one can be denied coverage because of preexisting conditions, and the rates for those plans are based solely on age and location – not on health status. Additionally, there is now a standardized system so that consumers can appeal any denial of payment decision.
- Limiting how much health care an insurance company would pay in a given year or over a lifetime is banned.
- Insurance companies must justify unreasonable rate hikes and must spend at least 80 percent of consumer-paid premiums on health care instead of administrative costs.
- Many preventive care services are covered at no cost with qualified health plans and with Medicare.
- The Medicare “donut hole” is closing and will be closed by 2020, which means seniors are saving on prescription drug costs.
- Medicare payments to hospitals and physicians are now linked to quality instead of quantity of services provided.
- States are given incentives to come up with innovative plans to improve the health of their citizens.
K-State Research and Extension has many resources available to help consumers understand health insurance and how it can help protect them against financial risk. That publication is available online, or contact any local extension office in Kansas.
K-State Research and Extension is a short name for the Kansas State University Agricultural Experiment Station and Cooperative Extension Service, a program designed to generate and distribute useful knowledge for the well-being of Kansans. Supported by county, state, federal and private funds, the program has county Extension offices, experiment fields, area Extension offices and regional research centers statewide. Its headquarters is on the K-State campus, Manhattan.
Roberta Riportella – email@example.com or 785-532-1942