Skip to main content

ACA At 12: Expanded Access to Affordable Care

By March 18, 2022No Comments

Ahead of the Affordable Care Act’s (ACA) 12th anniversary, Protect Our Care is highlighting the major achievements of the law each day leading up to March 23. The anniversary comes as enrollment is at an all-time high of 14.5 million Americans and premium costs are at a record low. President Biden and Democrats in Congress are continuing their work to strengthen the ACA by fighting to lower drug prices, reduce premiums, and expand coverage to even more families.  

Protect Our Care will host events this week celebrating the law’s success, despite years of attacks by Republican lawmakers. Twelve years later, the ACA is here to stay and stronger than ever. 

Day 3: The ACA Has Expanded Access To Affordable Care

Twelve years ago, the Affordable Care Act (ACA) became the law of the land and millions of Americans gained lifesaving coverage as a result. Thanks to the ACA, 19 million Americans have gained coverage through Medicaid expansion and a total of one in four Americans has coverage through Medicaid or CHIP. Once viewed as a safety net, Medicaid has evolved to demonstrate the overwhelming need and desire for affordable health coverage. Without question, Medicaid has become pillars of the American health care system. 

After years of Republican efforts to repeal and sabotage the law, President Biden and Democrats in Congress have made historic investments to secure the future of American health care. Thanks to their vision and determination, 2022 saw 83 million Americans receiving their coverage through Medicaid or CHIP. Americans can now sleep easier at night knowing that Medicaid expansion is here to stay and President Biden is hard at work to expand health coverage. 

A closer look at how the Affordable Care Act is expanding health care access across the country:

Allowed States To Expand Medicaid. Because of the ACA, states can access additional federal money to expand Medicaid. 12.5 million Americans were able to enroll in Medicaid during the COVID-19 pandemic, bringing the total of individuals covered by Medicaid and CHIP to more than 83 million, or one in four Americans. As of December 2020, 14.8 million Americans were enrolled in Medicaid due to Medicaid expansion and an additional 4 million previously-eligible adults gained coverage under expansion due to enhanced outreach, streamlined processes, and increased federal funding under the ACA. Between February and November 2020, states that expanded their programs saw a 22 percent increase in Medicaid enrollment. Additional research has shown that Medicaid expansion states were better positioned to handle the economic fallout of the pandemic, with fewer residents becoming uninsured. 

Key Support For Rural Hospitals. Through lower premiums and expanded Medicaid, the ACA has profoundly reduced uncompensated care costs, which are often the direct result of individuals who are un-or-underinsured. Compared to 2013, hospitals’ uncompensated care costs decreased by more than $14 billion in 2017, or 26 percent. Medicaid expansion plays a large role in reducing uncompensated care costs. When Louisiana expanded Medicaid in 2016, it experienced a 33 percent reduction in uncompensated care costs as a share of total operating expenses among hospitals, with a 55 percent reduction for rural hospitals.

Improved Health Outcomes And Saved Lives. A study published in the Journal of Health Economics found that Medicaid expansion reduced mortality in people aged 20 to 64 by 3.6 percent.  According to the Center on Budget and Policy Priorities, Medicaid expansion saved the lives of 19,200 older adults aged 55 to 64 between 2014 and 2017. At the same time, 15,600 older adults died prematurely as a result of their states’ decision not to expand the program. 

Medicaid Expansion Leads To Expansion In Available Services. Medicaid expansion has helped patients access preventative care, including colon cancer screenings. Expansion also increased patient access to kidney transplants and made diabetes medication more affordable for low-income patients. The program was also tied to earlier diagnosis of colorectal cancer and reducing diabetes-related amputations.

Children Benefit From Medicaid Expansion. When parents have health insurance, their children are more likely to be insured. A study in Health Affairs found that 710,000 children gained public coverage as a result of their parents enrolling in Medicaid between 2013 and 2015. 

When Medicaid Is Expanded, Income Inequality Drops. A January 2021 study found the ACA helped reduce income inequality across the board, but far more dramatically in Medicaid expansion states. The bottom 10th percentile of earners In Medicaid expansion states saw a 22.4 percent boost in their income, compared to 11.4 percent in non-expansion states. A 2019 study found that Medicaid Expansion also caused a “significant” reduction in poverty. 


Day 1: Patient Protections Of The Affordable Care Act

Day 2: The ACA Has Lowered The Cost Of Quality Health Care