March 23, 2012, marked the second anniversary of the enactment of the ACA, which has enabled millions of previously uninsured and underinsured children and adults to obtain coverage. Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services (HHS), highlighted the effect that some key consumer protections and private insurance market reforms in the law are having on young adults, individuals with pre-existing conditions, women and seniors. For example:
- 2.5 million young adults now have health insurance coverage by being allowed to stay on their parents’ health insurance plan up to age 26.
- Roughly 50,000 people with pre-existing conditions who had been previously denied insurance now have coverage through the federal Pre-Existing Condition Insurance Plan (PCIP).
- Lifetime limits were eliminated for roughly 105 million individuals.
- 5.1 million Medicare beneficiaries saved more than $3.2 billion on prescription drugs from the closing of the “doughnut hole.”
- 45.1 million women (including 20.4 million with private insurance and 24.7 million with Medicare) can receive recommended preventive services (i.e., mammograms, annual visits) without paying a co-pay or deductible.
Additionally, according to HHS, 74.8 million people have had reduced insurance premiums and lowered out-of-pocket costs as a result of regulating the amount insurers can raise premiums and controlling how the money from premiums is spent.
Despite these achievements, this monumental law remains highly controversial. On March 26, 2012, the Supreme Court began hearing arguments contesting the constitutionality of the law. The challenges are largely focused on the individual mandate, which requires all citizens to have health insurance coverage after 2014 or to pay a fine, and provisions that expand Medicaid eligibility to all individuals (including single adults) with incomes below 133% of the Federal Poverty Level (FPL) in 2014. The Supreme Court also heard arguments on whether it has jurisdiction to rule on the constitutionality of the law before the penalties have been implemented and how much of the entire ACA would need to be struck down if any individual elements are found to be unconstitutional. A decision by the high court is expected later this spring or early summer.
NHF is carefully monitoring this situation and will keep you posted as we learn more.