Dr. Clif CleavelandThe Affordable Care Act of 2010 (ACA) became a lightning rod for controversy in the recent presidential election. Winner Donald Trump pledged in his campaign to terminate the ACA as one of his first actions after inauguration.
Since his election, Trump has indicated that he would keep certain components of the ACA such as allowing dependents to remain on their parents’ health insurance coverage until age 26 and preventing higher premiums for persons with disabilities and pre-existing health conditions.
The Affordable Care Act of 2010 had three goals: expand coverage, control costs and increase efficiency.
Expanded coverage has been a major accomplishment. In 2013, 16.6 percent of non-elderly Americans were uninsured. That figure dropped to 10 percent in 2016. An all-time high of 90 percent of Americans now have health insurance. Twenty-nine million remain uninsured. Of these, 5 million were denied coverage by legislators in 19 states, including Tennessee and Georgia, who blocked Medicaid expansion. Political ideology overshadowed concern for the health of poor people.
Millions of Americans elect not to purchase health insurance, choosing instead to pay a fine that will increase in 2017 to $695 per adult, $347.50 per child or 2.5 percent of household income. Fines are capped at an amount equal to the least costly health plan offered in an insurance exchange or marketplace. These individuals are betting they will not need major medical or surgical care while avoiding payment of health insurance premiums that are often costlier than penalties.