How Critics Feel About Obama's Health Care Reform and the ACA

How Far Have We Come Since Obama's Affordable Care Act?

Team of doctors walking in hospital hallway
Criticisms of the Affordable Care Act. Buero Monaco/ Taxi/ Getty Images

When President Obama started talking about reforming health care, there was no shortage of criticism, now , well into President Trump's presidency, several attempts have been made to make change to the Affordable Care Act (ACA).

Finding affordable healthcare options is a great concern to many Americans, since the ACA changed the lives of many previously uninsured Americans who can now find affordable healthcare, either as a result of the programs being offered through the government-run marketplace, or through private insurance plans that have had to change in response to the changing American healthcare standards.

The ACA law provides income-based premium subsidies to those who purchase their own insurance through the marketplace to learn more about read: 10 Ways to Keep Your Health Care and Insurance Affordable​, no matter what happens next.

What Changed in Obama's Health Care Reform?

Before the ACA, there were a lot of criticisms, but there were also successes. The current health care reform is supposed to address many of the issues. It helps to look back and see what the concerns and data were to help understand where healthcare may be going in the near future.

Primarily people wondered if the government stepping in to help manage health care was the best way to go. The facts and statistics that we are able to see are showing a clear improvement in healthcare accessibility for many Americans, and although we have not yet reached a point where every single American is insured, the improvements were tremendous.

The groups who benefit the most from healthcare reforms appear to be those who were previously discriminated against and the most vulnerable of society like low-income families and seniors. 

 

Gallop Polls Showed a Decline in Uninsured Rates  

The percentage of adults who were uninsured dropped from 18% in the third quarter of 2013 to 11.9 in the first quarter of 2015, and was at 11.0% in the first quarter of 2016.

How Do the Stats on Healthcare Plans Look Today in 2017?

Some Facts on Obama's Affordable Care Act:

  • 20.5 million less people are uninsured than in 2010
  • There are various other plans available through the healthcare Marketplace to Americans
  • The Children’s Health Insurance Program (CHIP) has expanded to cover 9 million children.
  • Before the Affordable Health Care Act, insurers could reject people with pre-existing conditions, restrict coverage or even use very mild medical conditions to completely refuse individuals insurance. The ACA turned this around.
  • In 2014 and 2015, actual enrollment exceeded the original projections when the ACA was introduced
  • In the age group of 18–64 year olds, 70.5% (138.8 million) were covered by private health insurance plans by March 2017. 9.4 million of which were covered by private health insurance plans through the Health Insurance Marketplace or state-based exchanges

 

Here's What Some Criticisms of Obama's Reform and the ACA Have Been:

So why change things for the ACA if so many more Americans are now insured? Leading up to the passing of the Affordable Care Act, there were many criticisms, fortunately over time, many of the criticisms and fears have been proven wrong. Here are some of the more popular ones:

  1. As the years have passed, many people are becoming concerned that due to the high payouts following all these previously uninsured Americans now being insured, that the costs will be rising. Young males seem to be getting hit with the highest costs for health care, in particular after the premium increases of 2014, but on the flip side, women's rates have dropped and more young people are obtaining coverage.
  1. Some critics believe that the ACA has made health care less attainable for the middle class.That the only benefits have been widely for the low income, poverty level and unemployed. This is somewhat debatable since it certainly benefits all classes of people to be able to obtain insurance with pre-existing conditions. In comparison, when insurance companies are insuring greater numbers of sick people, the overall insurance rates will rise.
  2. The reform to Medicaid is left up to each of the states. The states that have not expanded Medicaid have left millions of the nations’ poorest without coverage options.The states who have not participated in the expansion are also seeing higher numbers in the uninsured. Some studies have even shown that these same states not only have lower insured numbers in the low income and unemployed but across the board in all income levels when compared to the states who participated in the expansion.
  1. Following the ACA, many employers altered the health insurance plans they were offering their employees, leaving the employed and insured in a potentially worse off position once changes were made. A study by Kaiser Family Foundation explored this further, and the actual data on the situation is neutral overall. 
  2. After the ACA almost 5 million Americans lost access to health care benefits due to the fact that the health insurers did not comply with the ACA standards. These Americans then had to apply for coverage through the marketplace and may have ended up paying more as a result. The same Kaiser study cited above reviews this data.
  3. Some have suggested that now being insured has created a cost shift that essentially is not helping those who were previously uninsured, because although they now have insurance, the costs of the deductible, co-pay and coinsurance are comparatively outrageous and so they will not seek out medical care. This criticism does not take not take into account provisions about essential services, or services that may even be free or not subject to deductibles or co-insurance. Furthermore, most would agree that some insurance is better than no insurance.  

It might be argued that carefully shopping the marketplace to find options that make the most sense for your personal situation could avoid outrageous costs. Understanding the terms of the policy you choose will help you make stronger decisions and save money long term

ACA Facts: According to HHS.gov, almost 80% of Marketplace shoppers using HealthCare.gov in 2015 could purchase coverage for $100 or less after tax credits 

Discussing the Pros and Cons of the ACA

According to Obamacare Facts (a privately owned informational website), there are most definitely pros and cons to the Affordable Health Care Act. The largest criticisms are probably around the fact that the law creates "obstacles for high earners, larger firms that don’t insure their employees, and certain sectors of the healthcare industry". Most Americans who can now find health care coverage due to the elimination of people getting rejected for pre-existing conditions and the increased access to heath care for the low-income and unemployed would probably agree that despite the fact that the ACA is not perfect, it has allowed for the insurance of millions of Americans.  

According to this White House Fact Sheet, over 85% of individuals newly covered by the ACA liked their coverage in 2015

The Most Common Reported Problems With Obamacare and a Driving Force For Reform

The largest criticism of Obama's healthcare reform is the fact that prices will have to eventually rise based on this model.

People are bracing themselves for increases, and many question whether the affordable health care they have been able to obtain will remain affordable and accessible. 

The second largest criticism was the fact that people just don't understand the marketplace or the health care reforms.

Increased understanding and awareness in the public and movement of the states that have not expanded Medicaid would address and solve a few of these key criticisms of Obamacare and make millions more uninsured Americans insured.  

Health Savings Account Changes by the Current Trump Administration

One thing that stands out in the current data by the CDC is that High Deductible Health Plan (HDHP)  enrollment increased 17% since 2010 and it now at 42.3%. Having an HDHP allows people to invest in Health Savings Accounts, which yield potential long term benefits for people, read more here. What is interesting is that Trumpcare looks to expand the benefits of HSA's including the possibility of lowering the penalty for withdrawing funds for the tax-free HSA from Obamacare's 20% to 10% when a withdrawal is made prior to age 65 for non-medical reasons. 

Yet, in the same data:

  25.3% who were enrolled in an HDHP did not have an HSA.

There are always improvements that can be made to current legislation and healthcare. The best way to protect yourself and ensure you get the maximum benefits for the money you pay into a health plan is to make sure you are maximizing on plans like HSA's, and being well informed about the coverage's you are entitled to as things change.