The Affordable Care Act: Pros and Cons Update for 2016
In this space in 2012, we examined the key pros and cons that were intended when the Patient Protection and Affordable Care Act (ACA) was signed into law. While supporters of the law projected lower costs, fewer people uninsured, and increased access to healthcare; the results so far may be a little different. Let’s take a look at what is working and what isn’t for the six-year-old law.
Increased Coverage. The ACA was slated to provide healthcare for more than thirty-two million Americans who were without coverage or underinsured. Other projected benefits included coverage for young adults up to age 25 through their parent’s health insurance plans, coverage for pre-existing conditions, and helping provide insurance for those living below the poverty level.
- Increased Coverage Update. Current data indicates that more than 16.4 million people gained coverage under the ACA since it was enacted in 2010. This number includes an estimated 3.4 million young adults who have stayed on their parent’s insurance plans until reaching age 26. Before ACA, an estimated 20.3% of the population were uninsured with that number dropping to 13.2% in 2015.
Reduced Healthcare Costs. The ACA was intended to reduce the costs of healthcare in general and more specifically was promised to reduce out-of-pocket costs by an average of $2,500 per family.
- Healthcare Costs Update. The biggest benefit from the original promise of the ACA was reduced out-of-pocket costs for individual families. Unfortunately, that promise has not yet been kept. Average premiums have increased almost $4,000 since 2009, and the health care plans that promote lower premiums include higher deductibles in excess of $1,500 per person.
Reduced Budget Gaps. In our 2012 review of the Pros and Cons of the ACA, we cited a report from the Congressional Budget Office (CBO) stating that the ACA would reduce the national deficit by $143 billion by the year 2019, due to the increased taxes and fees generated by the legislation.
- Federal Deficit/Budget Gap Update. In the past year, mandatory government spending (all essential programs) will be almost $200 billion more than the previous year with more than 50% of that attributed to healthcare spending. According to a report filed by the Government Accountability Office (GAO), the ACA will increase the long-term deficit by more than $6 trillion if cost controls are not sustained.
Shortage of Healthcare Professionals. One of the greatest fears prior to the implementation of the ACA was that the increase in patient populations, coupled with an aging “baby-boomer” population would lead to a shortage of primary care physicians over the next decade.
- Shortage of Primary Care Physicians Update. In a December 2015 report issued by the American Association of Medical Colleges (AAMC), the projected shortfall of primary care physicians is expected to be in the range of 12,500 and 31,000 by the year 2025. This projected shortfall is down from the 52,000 shortage projected in 2012. While overall the demand for services is still exceeding the projected numbers of physicians, the shortfalls have generally decreased due to an increased number and role of advanced practice clinicians.
Higher Drug Costs. The ACA contains a number of fees and taxes levied against Pharmaceutical companies, which were expected to be passed onto consumers as the law is implemented. The increased costs to drug manufacturers were anticipated to be offset by an increase in the number of patients being prescribed medications.
- Drug Cost Update. There have been some changes in the Pharmaceutical industry since the ACA was passed into law. We have been witness to large scale mergers, workforce downsizing, and a decrease in research spending. These changes all portend a continuing increase in the cost of prescription drugs as major pharmaceutical companies have raised prices up to 10% across the board.
To date, the one constant that we have had with this ground-breaking health care reform legislation is that it is controversial. As supporters and detractors continue to argue about the merits of ACA, we the people can only stay informed and make our best decisions about what is right for our situation and families. For more information about the Affordable Care Act, visit our recap of the ACA’s history.