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The Affordable Care Act’s Anniversary
On the 11th anniversary of its signing, President Joe Biden celebrated the Affordable Care Act (ACA), calling it “the most consequential piece of healthcare legislation since the creation of Medicare and Medicaid.” The event was held in the White House’s East Room in March 2023.
“Big F****** Deal”
During the event, President Biden recalled his enthusiasm for the ACA when he was vice president under Barack Obama: “big f****** deal.”
What is the ACA?
The ACA, or “Obamacare,” was signed by President Obama in 2010. It aimed to expand access to health insurance through subsidies and state-led Medicaid expansion efforts, as well as lower healthcare costs. Additionally, it prohibited insurance companies from denying coverage or charging more to people with pre-existing conditions and allowed young people to stay on their parents’ insurance plans until they turn 26.
Progress and Success in Arkansas
In 2014, when most provisions went into place, nearly 12.6 million Americans received health insurance through federal- or state-operated insurance marketplaces or Medicaid expansion. Today, the number of people who received insurance through “Obamacare” has eclipsed 40 million.
Arkansas has more than 435,000 residents with insurance through the ACA, including 342,505 through Medicaid expansion. According to Christen Linke Young, deputy assistant to the president for health and veterans affairs, “since the law was signed by President Obama 13 years ago, it has provided life-saving protections to countless families across the state.”
Medicaid Expansion Benefits
Arkansas was one of the first states to expand Medicaid under the ACA, increasing the income threshold for eligibility to 138% of the federal poverty level. Before, Medicaid was mostly limited to pregnant women, children, the elderly, and people with disabilities.
Robin Rudowitz, who leads the Kaiser Family Foundation’s program on Medicaid and the uninsured, said people with Medicaid face less medical debt and smaller out-of-pocket costs compared to other patients, and more people can access health screenings and services as a result of the expansion efforts. Rural health care providers have also benefited from Medicaid expansion.
Upcoming Changes to ACA
However, millions of Americans could lose Medicaid coverage in the coming weeks as the national coronavirus public health emergency ends. At the start of the pandemic, Congress allowed more Americans to enroll in Medicaid, and the federal government prohibited states from ending coverage while the order remains in effect. The final day of the public health emergency is next Friday, and every person on the Medicaid program will have to undergo a renewal. People ineligible for Medicaid could receive coverage through other programs, but they might need assistance to find the best option.
Biden Administration’s Efforts to Support ACA
Biden and White House officials are hoping to ensure the ACA’s sustainability, citing the current congressional makeup. Last year’s Inflation Reduction Act extended enhanced ACA subsidies through 2025. The president has requested a permanent extension of these payments, which the White House estimates will save families $800 a year. However, the discussion is still focused on budget cuts and the debt ceiling, which could result in cuts to Medicaid and other health programs.
The Future of the ACA
Despite facing challenges and questions since its enactment in 2010, the ACA has survived. Court challenges and congressional Republicans’ attempts to repeal the law have not been successful. Rudowitz said that discussions on budget cuts and the debt ceiling might result in cuts to Medicaid and other health programs, but the conversation is not about repealing and replacing the ACA like in previous years of major Republican efforts.
