After Five Years With The ACA, Approval Is Low But Success Is High

The end of March marked the five-year anniversary of the Affordable Care Act being signed into law by President Barack Obama.

“It’s working despite countless attempts to repeal, undermine, defund and defame this law,” Obama said in his speech during the anniversary ceremony on March 23.

The Affordable Care Act is responsible for a number of significant changes to health care requirements for insurance companies, employers and individuals.

Insurance companies are no longer allowed to deny coverage because of a preexisting condition. There are no longer any annual or lifetime limits. Preventative care is now covered at no cost. Companies are no longer allowed to charge women at higher rates than men, and any young adult is now allowed to stay on his or her parent’s plan until turning 26 years old.

Regular individuals are now required to have coverage for a majority of the year or pay a penalty tax. Likewise, employers with more that 100 full time employees are now required to provide an affordable plan or pay a tax penalty.

All the while, these changes have been met with constant disapproval and derision. Even now, the future of law is uncertain, as the Supreme Court is expected to make a decision on the case King v. Burwell, which could have drastic effects on peoples’ eligibility for subsidies.

And the now GOP-dominated Congress has already put plans in motion to make changes to the employer mandate, which has been so hotly contested since the enactment of the law.

One thing is certain though — the Affordable Care Act has provided people with the resources and incentives necessary to get coverage. As of March 2015, more than 16 million people were covered because of the federal and state exchanges, Medicaid expansion, and the provision allowing young adults to remain on their parents’ plan.

It’s the primary point Obama focused on in his speech, the difference the law has made in getting people the coverage they need.

“For folks who are basing their entire political agenda on repealing the law, you have got to explain how kicking millions of Americans off their insurance is somehow going to make us more free.”

Overall approval of the law among Americans is still split, but the gap between favorable and unfavorable opinions has narrowed to the closest margin in two years, with 43 percent opposed to the ACA and 41 percent in favor, according to the Henry J. Kaiser Family Foundation.

Approval among employers is still low, as in some cases it has required an increase in coverage or implementation in plan administration. Recently, in two separate House subcommittee meetings, employer and industry representatives testified about the effectiveness of the mandates as well as expressed real-world experience with the law.

Sally Roberts, director of human resources at Morris Communications Company, who testified on behalf of the Society for Human Resources Management said she now spends twice as much time administering benefits.

“The ACA has made benefits much more complicated than they were before,” she said to Employee Benefit News.

However, the law has not had quite the adverse effect on business or insurance plan rates that was once predicted. In fact, premium increases are significantly lower than they have been in the last 50 years.

Premiums for family policies in the group market grew by 72 percent between 1999 and 2004; 34 percent between 2004 and 2009; and 26 percent between 2009 and 2014.  But in 2014, premiums increased by only 3 percent, according to the Henry J. Kaiser Family Foundation.

It’s perhaps because of these victories that Obama remains optimistic about the progress and future of the law, despite all of the issues so far.

“We’ve made our share of mistakes since we passed this law. But we also know without a shred of a doubt that the policy has worked. Coverage is up. Cost growth is at a historic low. Deficits have been slashed. Lives have been saved”

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