The debate over the Affordable Care Act (Obamacare) certainly isn’t over, but millions of Americans who acquired insurance through this new system can rest assure for now.
President Obama’s health care reform survived a critical challenge Thursday, with the United States Supreme Court giving the green light for subsidies in 34 states that didn’t establish insurance exchanges of their own.
Political and legal challenges are still ahead for the Affordable Care Act, or ACA.
President Obama and ACA supporters assert that ACA is here to stay but there is much work that needs done to fix and expand reform. Critics are standing their ground, suggesting that premiums in many areas could rise considerably next year and beyond, but so far data shows that the ACA hasn’t had a major impact, one way or another, on non-ACA health premiums.
One thing seems certain: Millions more Americans are insured now than before the ACA took effect.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible we must interpret the Act in a way that is consistent with the former, and avoids the latter,” wrote Chief Justice John G. Roberts in the majority opinion.
The high court ruling was particularly good news for hospitals, which are likely to see fewer uninsured patients in emergency rooms. According to the latest filings, about 10.2 million people had signed up and paid their insurance premiums through the exchanges as of March. And 6.4 million were receiving subsidies to help afford coverage in the 34 states that had not set up their own marketplaces. Those consumers were at most risk of losing their coverage had the high court ruled the other way.
Rand Corporation researchers last month estimated that from September 2013 to February 2015, 22.8 million Americans became newly insured and 5.9 million lost coverage, for a net of 16.9 million newly insured Americans.
The Rand study estimates 11.2 million Americans are insured through new state and federal marketplaces created under the Affordable Care Act, including 4.1 million who are newly covered and 7.1 million people who transitioned to marketplace plans from another source of coverage.
The number of insured Americans could grow as more consumers become emboldened to apply for coverage now that they now the ACA has survived another major challenge and is likely not going away. Moreover, the high court ruling may encourage more states to adopt their own exchanges, although that may rely too much on a political sea change in Republican-led states, which is unlikely in a presidential election period.
A big factor in the growth of ACA enrollment, of course, is health plan prices.
A new Kaiser Family Foundation analysis of ACA plans in major metropolitan areas in 11 states where data are available, including the District of Columbia, finds that preliminary 2016 premiums for benchmark silver plans grew modestly. But the increases were sharper this year than last year.
The average increase for benchmark plans across the cities is 4.4 percent for 2016, compared with a 2 percent increase nationwide in 2015.
According to Kaiser:
Silver plans are the most popular with marketplace enrollees, selected by 68 percent of enrollees. The benchmark silver plan is the second lowest-cost silver plan available in each market, and its rates are used to determine the size of premium tax credits available to low- and moderate-income enrollees, regardless of which plan they choose.
Following the Affordable Care Act’s second open-enrollment period, most people enrolled in marketplace plans reported being satisfied with their plan’s coverage and features, according to a survey by Kaiser released late last month. A large majority (74 percent) of those in marketplace plans rated their coverage as excellent or good.