Over the last 14 years, the ACA has helped tens of millions of Americans gain access to affordable health coverage. Thanks to President Biden’s efforts to lower the cost of health care, a record-breaking 21.3 million Americans signed up for coverage through the Marketplaces for 2024. President Biden built upon the ACA by further lowering premium and prescription drug costs through the Inflation Reduction Act. The new law has lowered annual premiums for people who buy their own coverage by an average of $2,400 per family and has saved the average 60-year-old couple with a household income of $75,000 approximately $1,900 in monthly premiums for Marketplace coverage. Building on the ACA’s closure of the prescription drug donut hole, President Biden’s Inflation Reduction Act reduces out-of-pocket drug costs for Medicare enrollees by capping monthly insulin costs at $35, providing recommended vaccines at no cost, introducing a new annual out-of-pocket spending cap, and negotiating lower drug prices.
The ACA has survived countless repeal attempts and now it’s stronger than ever. Yet Republicans still want to destroy the ACA and all of its protections for over 100 million people with pre-existing conditions. Donald Trump has fully reignited his calls to repeal the ACA. As Trump is escalating his threat, Republicans in Congress and their allies are working overtime to dismantle reproductive care and access to vital preventive care, hike premiums, slash Medicare and Medicaid, reverse recent coverage gains, and raise prescription drug costs for the American people.
This week, Protect Our Care is highlighting five key ways the ACA is working across the nation:
Monday, March 18: How the ACA helps women
Tuesday, March 19: How the ACA helps seniors & young people
Wednesday, March 20: How the ACA helps people with pre-existing conditions
Thursday, March 21: How the ACA helps people of color
Friday, March 22: How the ACA expanded affordable coverage to tens of millions of Americans
Background:
Among the many benefits of the ACA, the health care law ensures that the more than 50 million people enrolled in Part D coverage who may have otherwise fallen into a prescription drug coverage gap “donut hole” have their vital medications covered. The ACA guarantees no-cost coverage of preventive services, which has led to an increase in utilization among seniors and a decrease in catastrophic health costs. The ACA also laid a strong foundation for the Inflation Reduction Act’s measures to lower drug prices, including the new out-of-pocket cap on drug costs that went into effect in January 2024 and drops to $2,000 out-of-pocket cap in 2025, which will save nearly 19 million seniors about $400 per year. These benefits, along with the expansion of Medicaid, have improved the health of seniors across the country.
By the Numbers:
- Over 50 million seniors are protected from the Medicare ‘donut hole’ coverage gap.
- Lifesaving free preventive care has led to an increase in utilization with one study showing that implementation of the ACA led to a 9 percent increase in colonoscopies among seniors.
- The Balancing Incentives Program under the ACA has led to a 3.2 percent increase in daily home caregiving and better quality care for seniors.
- Spillover effects from ACA coverage have resulted in a 17.4 percent increase in SNAP enrollment, leading to better health outcomes among low-income seniors.
- The ACA’s 2014 Medicaid expansion led to seniors being 4 percent more likely to have dual Medicare and Medicaid coverage, allowing for more affordable health care and better health outcomes.
- Through Medicaid expansion, 7.2 million Americans over 65 are enrolled in Medicaid and more than 8.5 million Americans ages 50 to 64 have health coverage.
People Over The Age Of 50 Save Thousands On Premiums. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, according to AARP. People who buy insurance on their own, especially early retirees, have been able to save thousands on health insurance thanks to the enhanced premium subsidies passed in the ARP and extended in the IRA.
Seniors Are Guaranteed Free Preventive Services And Annual Check-Ups. Around 61 million people with Medicare have access to free preventive services because of the Affordable Care Act. Additionally, Medicare beneficiaries likely see lower premiums thanks to the cost-saving measures implemented under the ACA.
Millions of Medicare Beneficiaries Are Benefiting From Higher Quality, More Coordinated Care. Provisions in the ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated high-quality care to the Medicare patients they serve, affecting nearly 9 million seniors.
32 Million Older Adults With Pre-Existing Conditions Gained Protections. Thanks to the ACA, people with pre-existing conditions like asthma and diabetes cannot be charged more or denied coverage by their insurers. Nationwide, half of all Americans have a pre-existing condition, including 32 million people aged 55-64. And now, millions of Americans who have contracted the coronavirus are also protected from discrimination by their insurance companies.
A Closer Look At How The Affordable Care Act Is Working For Seniors Across The Country:
Seniors Saved Thousands On Prescription Drug Costs Thanks To The ACA. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 Centers on Medicare and Medicaid Services report.
The ACA’s Medicaid Expansion Saved The Lives Of At Least 19,200 Older Adults. 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 state’s decision not to expand the program.