Many people are confused about what the ACA is actually supposed to do. One of the biggest ACA reforms is the establishment of public health insurance exchanges, which are like marketplaces that allow individuals and families to seek out and buy affordable and comprehensive health insurance plans. The ACA also provides increased government subsidies to help low and middle-income families afford health insurance. Additionally, it prohibits insurance companies from refusing service or charging higher rates to people with pre-existing conditions, making health insurance more affordable and accessible to all. The ACA also prohibits insurance companies from placing an annual or lifetime cap on how much money they’re willing to pay for an individual’s healthcare. Finally, the ACA requires all companies with at least 50 employees to offer affordable, comprehensive health insurance to all of their full-time employees.
Although the ACA has made considerable strides towards the goal of achieving universal health coverage for all Americans, it’s not a perfect system, and has faced considerable pushback, especially from Republican politicians. One of the ACA’s major flaws involves Medicaid, a program established in the 1980s to provide affordable healthcare for low-income Americans. When the ACA was first established, one of its main goals was to expand Medicaid to all 50 states in the hopes that more low-income individuals could gain access to affordable health insurance. However, in 2012, the Supreme Court declared the expansion of Medicaid unconstitutional, which means that individual states are still allowed to opt out of providing expanded Medicaid coverage to their residents. As of 2019, 37 states (including Washington DC) have adopted the ACA’s Medicaid expansion, but 14 states have chosen not to. This has created a coverage gap for low-income individuals in these 14 states, which means that about 2 million Americans still do not have affordable or accessible health coverage. Until all Americans, including those who live at or under the poverty line, are given access to affordable healthcare, we cannot claim to be a nation that values the fundamental human right of health.
In March of 2019, the Trump Administration announced that it wanted to overthrow the entire Affordable Care Act, nullifying advances in healthcare coverage for over 30 million Americans. To do this, the Trump Administration is banking on a lawsuit against the ACA, Texas v. Azar, which seeks to declare the entirety of the ACA unconstitutional. Legal scholars are divided on whether or not this lawsuit poses a serious threat to the ACA, so in the coming months, the Texas v. Azar suit is definitely something to keep your eye on if you’re interested in following the debate surrounding the ACA. To combat the Trump Administration, House Democrats recently introduced a bill to strengthen the Affordable Care Act. Provisions in this bill include increasing subsidies for low-income individuals, expanding federal assistance to include individuals at higher income levels, and fixing the ACA’s notorious “family glitch,” which currently makes it difficult for employed individuals to afford insurance plans that include their spouses and children. However, because of rampant partisanship in Congress, it’s still unclear whether this bill will make any ground.
Universal healthcare and ‘Medicaid for All’ has become the battleground of a fierce partisan debate, with Republicans and Democrats vying for political power by trying to repeal or strengthen the ACA. Although the debate swirling around universal health coverage and the ACA can be incredibly tense and confusing, it’s important to always keep in mind the core tenet of human rights that serves as the foundation of the argument for universal healthcare. Regardless of what form it ends up taking, access to quality healthcare is a fundamental human right, and every attempt to deny this healthcare is a degradation of the United States’ commitment to upholding human rights.