There is a chance that a big Republican win could mean changes to the law
A decade after the ACA: Donald Trump’s fight against the Affordable Care Act is a priority for the future of the American public, writes Larry Levitt
Tradeoffs is a nonprofit news organization that reports on health policy. Dan is the executive editor. The story was produced by Ryan Levi. Tradeoffs’ Deborah Franklin adapted this story for web. You can listen to the full interview here:
When the ACA went into effect, the price of health insurance policies you buy on your own went up. That’s because insurers had to provide coverage for preexisting conditions, had to provide certain essential required benefits – they had to cover more stuff.
President Trump wanted to give states a lump sum of money and let them use that money as they please, which is why he proposed converting the Medicaid program into a block grant. We’ve seen similar plans, for example, from a group of conservative Republicans in the House that would also convert Medicaid in the ACA into a block grant to states, remove federal protections in the insurance market, and cut federal spending by $4.5 trillion over a decade.
We’ve been polling for more than a decade and a half about the ACA. … It was quite controversial when the act was being debated. That changed when Republicans tried to repeal and replace it in 2017. The ACA was more popular than at any point before, and has since grown more popular. Now, 62% of the public views the ACA favorably. That’s dramatically different than when over half the public viewed it unfavorably. More and more people have benefited from the law, which went into effect over a decade ago.
The speaker of the house told a crowd at a campaign stop in Pennsylvania that they need to reform the health law. He promised a first 100 days agenda if Trump is elected. “Health care reform’s going to be a big part of the agenda,” Johnson said.
As part of a major speech on Tuesday in Washington, D.C., Harris warned Americans of what could happen if the ACA were to be repealed. If Donald Trump succeeds in getting rid of theAffordable Care Act, then you will pay more, just like when insurance companies were able to deny people with pre-existing conditions.
The upcoming elections may have an impact on the law according to Larry Levitt, an executive vice president of KFF. Levitt has studied the ACA since its inception.
He recently gave insight into the track record of the health care law, and what it might mean for the Republicans to reform it. Here are highlights from that conversation.
Over a quarter of adults under age 65 have a preexisting condition that would have led to a denial of insurance before the ACA. This is something that doesn’t affect a lot of people.
There is a tax credit for people who are very low-income that the federal government can give. … In this country, obtaining health insurance is very expensive. The cost of health insurance for a family is more expensive than buying a car. For the majority. [who don’t have job-based insurance], without the federal help to pay a portion of the premium, they simply couldn’t afford coverage.
The quality of coverage has gone up, I think. Insurance companies provide benefits that are more comprehensive. There are conditions that are covered by it. All of these benefits are covered.
Now, health insurance generally is still far from perfect. The doctors and hospitals insurers cover are often quite narrow. It can be difficult to get an appointment. That’s not true just under the ACA. It is true for people that have insurance through their employer. Health insurance is certainly not perfect, but I don’t think you can blame the ACA for that.
Donald Trump said in the debate that he has a plan for what to do with the health care law, but he didn’t say what it was. Vice President Harris says she wants to preserve the law and improve on it.
A rule that lets low income people enroll in a marketplace health plan at any time of the year was added to the program in 2025, in addition to the fall open sign up period. The Medicaid program works for people with low incomes.
But this could be the high watermark for enrollment in these plans, depending on who is elected president and whether the next Congress acts to keep extra federal subsidies, which have made the health plans so affordable.
Most Americans get their insurance through their job, or through a government program. But still, this program has a big impact. The number of uninsured Americans has dropped dramatically since new records were set in the marketplaces.
For many people, premiums are $10 or less a month, and there are more plan options than ever. Cynthia Cox is the director of the Program on theAffordable Care Act for KFF, a nonpartisan health research organization.
“Under President Biden and Vice President Harris, more Americans have access to a doctor, a hospital through their own health insurance than ever in the history of the country,” Secretary of Health and Human Services Xavier Becerra tells NPR. After this year’s open enrollment, he adds, “I have no doubt that we’ll see another record set of Americans who have health care coverage.”
The Deferred Action for Childhood Arrivals recipients are one new group that is eligible for the subsidized marketplace plans. Secretary is estimating that 100,000 people will enroll in the program.
“It’s a good day for all these folks because for the longest time they’ve been working [and] paid taxes and not had a chance to get their coverage through the Affordable Care Act — that changes,” he says.
Camila Bortolleto is one of the Dreamers who’s been waiting for this. She came to the US with her family when she was nine. She’s now 36, living near Danbury, Ct., and uninsured, since her job with health benefits ended over the summer. She went to urgent care when the dog bit her a few weeks ago and had to pay out of pocket.
“It is stressful,” she says. “I do need to get a checkup. I need to see a dentist. You never know when a random emergency is going to happen. She was going to sign it up as soon as possible.
US Health Secretary Xavier Becerra has said that he has no doubt that “we’ll see another record set of Americans who have health care coverage” after this year’s open enrollment, which ends on October 15. “Under President Biden and Vice President Harris, more Americans have access to a doctor, hospital through their own health insurance than ever in the history of the country,” he added.