Affordable Care Act (ACA)

The Affordable Care Act, also known as the ACA, refers to the overall healthcare reform endorsed by signature of the former U.S. President Barack Obama. The law presupposes a list of policies in the health sector geared to enhance access to medical insurance for hundreds of uninsured social groups. 

In fact, the Act extended the right to enter the Medicaid program, established a health insurance exchange, placed Americans under an obligation to receive medical plans, as well as restrained underwriting companies from refusing coverage on the basis of pre-existing terms. In addition, the law offers the possibility for young people to stay on their parent’s insurance program up to age 26.

Essence of the concept

Actually, the Affordable Care Act was set up in order to lower the price of healthcare plans for entitled individuals. The policy encompases premium tax credits, along with burden-sharing reduction, while the aim is quite simple: to assist in cutting down expenses for low-income households. 

Notably, premium tax credits diminish an individual's medical insurance every month. At the same time, burden-sharing reduction depreciates a person’s cash outflows for deductibles, extra payments, and co-insurance. It also alleviates the out-of-pocket maximum, meaning that the annual sum of healthcare expenditures decreases.

Any medical insurance scheme that meets the ACA requirements is subject to cover particular list of issues:

• outpatient treatment;
• breastfeeding;
• medical facilities for children;
• rescue services;
• laboratory tests;
• facilities for mental well-being and disorders caused by the use of psychoactive substances;
• family planning;
• hospital confinement;
• pregnancy, parenthood and neonatology;
• prescription drugs;
• health-improvement facilities and medical maintenance of chronic diseases;
• rehabilitation services.

Moreover, the Affordable Care Act specifies that a majority of insurance programs, involving the plans on the Health Insurance Marketplace, must defray expenses on preventive facilities. These services consist of patient’s checkups, vaccination, counseling appointments, as well as frequent medical examinations. Therefore, the ACA enables an application of Medicaid to a broader audience. According to statistics, almost 40 states in the U.S. have already used the options provided by the Affordable Care Act.

In reality, there exists a specific enrollment interval on the Marketplace, which is intended for purchasing or changing insurance programs. In case of running out of time, an individual isn’t able to place a request until the next year. The only exception from this rule is a marriage, divorce, delivery of a child, or job loss. 

Specific notes

A key component of the Affordable Care Act was the personal mandate, i.e. a law article stipulating the U.S. residents to obtain medical coverage. In case of non-compliance with the requirement, tax penalties were provisioned. Nevertheless, the liquidation of the mandate took place in the late 2010s.

Actually, a dual objective was singled out in the mentioned law article: to distribute medical care among the uninsured population, and to make sure that there was a wide spectrum of policy holders to assist in medical insurance pay-offs.

Views towards the ACA

The ACA, or Obamacare, is the first major US healthcare reform since 1965 to provide universal medical insurance. Preceding the policy, about 85% of the U.S. population had coverage. Nowadays, almost 91% of citizens possess these healthcare plans. The former President Barack Obama called this breakthrough as one of his main achievements being the head of the U.S.

In contrast, some experts believe that it was the Affordable Care Act that led to even greater confrontation between people with conservative and progressive views. According to many Americans, this failed healthcare reform also largely contributed to the loss of the Democrats' parliamentary majority.

Historical development of the concept

Since Barack Obama resigned office, a series of major changes has come into play. Let’s take a closer look. 

Presidency of Donald Trump. In the months before and after winning the presidential race, Donald Trump raised the issue of reversing the Affordable Care Act. He argued that Barack Obama's reform led to the emergence of insurance monopolies in certain states, and also caused a general increase in health care costs. It led to negative changes in the Marketplace, including the exit of particular corporations. In addition, low-income insurance was no longer affordable for middle-class Americans.

Moreover, a significant part of the young population was dissatisfied with the need to buy health insurance without fail, if it is not provided by the employer. According to particular social groups, one-time visits to doctors could be cheaper.

That’s where Trump and his administration presented the alternative Affordable Care Act. Most of the bill remained intact. Particular measures left the same, for instance, allowing the children under the age of 26 to be included in the insurance plan. Or, state subsidies in the form of a tax deduction have been preserved.

At the same time, a number of fundamental changes took place. One of the main components of Obamacare was excluded from the new bill - the obligation to purchase health insurance for all citizens under the threat of a fine. It was proposed to abolish state subsidies for social groups in material need, including payment for emergency hospitalization, medicines, pregnancy management and pediatric care.

Presidency of Joe Biden. Later, the U.S. President Joe Biden signed executive orders that overturn Donald Trump's initiatives in medical insurance and women's health.

In addition, the U.S. leader also signed an ordinance, introducing a special enrollment period in the Health Insurance Marketplace that could help people during the coronavirus. Employer coverage is the most common way Americans receive medical insurance, and during the pandemic, when lots of citizens have lost their jobs, the number of uninsured people in the U.S. has risen.

Joe Biden also lifted a ban on the allocation of federal funds to non-governmental organizations that inform about abortion, as well as advocate for their decriminalization.