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Affordable Care Act

Resources that contain information about the Affordable Care Act (Obamacare)

Very Brief History of the Affordable Care Act (through July 2021)

The Patient Protection and Affordable Care Act (PPACA), commonly called Obamacare or the Affordable Care Act (ACA), was passed by Congress and then signed into law by President Obama on March 23, 2010. Since then there were many attempts to repeal it and lawsuits filed against it. On June 28, 2012, the Supreme Court rendered its first landmark decision to uphold the law. The last legal challenge to the law was decided on June 17, 2021, and did not change the current ACA. Here are quotes and links to a few articles discussing the ACA's history over the last decade: 

According to the Kaiser Family Foundation (KFF): 
    "Under the ACA, as of 2014, Medicaid coverage expanded to nearly all adults with incomes at or below 138% of poverty in states that have adopted the expansion, and tax credits are available for people with incomes up to 400% of poverty who purchase coverage through a health insurance marketplace. Millions of people enrolled in ACA coverage, and the uninsured rate dropped to a historic low by 2016. Coverage gains were particularly large among low-income adults in states that expanded Medicaid." (KFF, 2019).

KFF. (2019, January 25). The Uninsured and the ACA: A Primer - Key Facts about Health Insurance and the Uninsured amidst Changes to the Affordable Care Act.

Things changed with the new Trump Administration in 2017. A January 2019 article in the National Review discussed it from a conservative point of view:
     "Starting this year, the individual mandate is dead. If you like your lack of health insurance, you can keep it--without owing a penalty to the government. This is the only big change to the law that a Republican Congress was able to pull off over two years in power, and with the Democrats having taken the House, it will likely be the last major health reform of this presidential cycle. Combined with Trump-administration regulatory adjustments that make it easier to buy cheaper and less comprehensive coverage outside of Obamacare, though, it has the potential to significantly reshape the individual market" (VerBruggen, 2019). 

VerBruggen, R. (2019, January 28). The New Obamacare: Congress and the President have remade the law. National Review, 71(1), 33+.

In November 2018, economist Paul Krugman wrote that states where the Democratic party is in control could help keep the ACA working well, and referred specifically to New Jersey:
     "And the importance of state-level action has only increased in the past two years, as the Trump administration and its congressional allies, unable to fully repeal the A.C.A., have nonetheless done all they can to sabotage it……All of these measures acted to drive premiums up and enrollment down. But states can, if they choose, fill the Trump-size hole."

     "The most dramatic example of how this can be done is New Jersey, where Democrats gained full control at the end of 2017 and promptly created state-level versions of both the mandate and reinsurance. The results were impressive: New Jersey's premiums for 2019 are 9.3 percent lower than for 2018, and are now well below the national average. Undoing Trumpian sabotage seems to have saved the average buyer around $1,500 a year" (Krugman, 2018).

Krugman, P. (2018, November 23). Democrats Can Deliver on Health Care. New York Times, p. A27(L).

In March 2019, "President Trump reignited the fight over Obamacare ... when his administration supported a lawsuit challenging the Affordable Care Act’s constitutionality" (Turner 2019).

     "The Trump administration on Monday said the entire Affordable Care Act should be struck down, in a dramatic reversal. In a filing with a federal appeals court, the Justice Department said it agreed with the ruling of a federal judge in Texas that invalidated the Obama-era health care law" (de Vogue & Luhby, 2019).

But people with health insurance from the ACA exchanges will still have their insurance for the time being, since the decision is on hold while being appealed (Turner, 2019).    

Turner, A. (2019, April 8). Trump is targeting Obamacare again. Here’s everything you need to know about where the law stands now.

de Vogue, A. & Luhby, T. (2019, March 26). Trump administration now says entire Affordable Care Act should be struck down. CNN Politics.

In November 2020, after the election, the Supreme Court heard oral arguments on the constitutionality of the ACA; a decision will be made before summer 2021:

    "On November 10, 2020, the Supreme Court heard about two hours of oral argument over the constitutionality of the individual mandate and the fate of the entire Affordable Care Act (ACA).... It is notoriously difficult to predict the outcome of a case from oral argument alone.... But the comments and questions on severability, especially those posed by the Chief Justice Roberts and Justice Kavanaugh, suggest that the rest of the ACA will be upheld even if the mandate is unconstitutional. A decision is expected next spring at the earliest" (Keith, 2020).

Keith, K. (2020, November 11). Supreme Court Arguments: Even If Mandate Falls, Rest Of Affordable Care Act Looks Likely To Be Upheld. Health Affairs: Follow the ACA [blog] 

On June 17, 2021, the U.S. Supreme Court voted 7-2 against the plaintiffs in the Texas v California case that tried to dismantle the ACA again:

     "The Supreme Court rejected a challenge to the Affordable Care Act from Republican-led states in a 7-2 decision, ruling they lacked standing to bring the case....The decision underscored that the court, even with the recent addition of more conservative justices, at times is still able to find broad coalitions supporting middle-ground outcomes in hot-button cases" (Kendall et al., 2021).

     "The Affordable Care Act survived its third major Supreme Court challenge... The law has gone from a 5-4 majority in its favor in the first case to Thursday’s 7-2 split. The decision secures the health law as a major legacy of the Obama era — the largest expansion of health coverage in decades — after years of hard-fought and politically painful battles.
    Obamacare enjoys higher-than-ever public support, with most Americans now favoring the law. Enrollment in the health law’s programs is at a record high. Democrats have moved from defending the 2010 law to expanding its benefits. While Obamacare remains a dirty word in some Republican circles, its repeal is no longer a focus of the party or a galvanizing issue among its voters....Fights about health policy are sure to remain heated, but they will be about what comes next. Democrats are still divided over many leading proposals, even if they remain united in their support of their past work" (Sanger-Katz & Kliff, 2021).

Kendall, B., Bravin, J., & Armour, S. (2021, Jun 18). Supreme Court rejects challenge to ACA --- justices rule 7-2 against lawsuit by Republican-led states to scuttle health law. Wall Street Journal.

Sanger-Katz, M., & Kliff, S. (2021, Jun 17). Obamacare is here to stay. Brace for new health care battles. New York Times.

On January 10, 2024, the CMS said  that enrollment for 2024 ACA plans had broken 20 million so far, the highest participation ever:

    “Today, we hit a major milestone in lowering costs and ensuring all Americans have access to quality, affordable health care: a record-breaking 20 million Americans have enrolled in health care coverage through the Affordable Care Act marketplaces,” President Biden said Wednesday. “With six days left to still get covered, 8 million more Americans have signed up for ACA coverage than when I took office.” 

Choi, J. (2024, January 10). ObamaCare enrollment breaks record for third consecutive year. The Hill