This week marks the fifth anniversary of the signing of the Affordable Care Act, best known to its friends and enemies as Obamacare.
Despite its many flaws and continued revilement by its critics, an estimated 20 million Americans have gained health coverage since the law was enacted, many of them African-American, Latino, women and young adults, according to the White House press office.
For working baby boomers not yet 65 and so not eligible for Medicare, the ACA’s provisions provide important options. Because the law requires almost all Americans to have comprehensive health care coverage, it sets up income-based subsidies to lower costs and also establishes online insurance “marketplaces” where consumers can compare plans and be assisted in selecting one that works for them. This provision takes pressure off all working adults, allowing more flexibility in employment, entrepreneurship and early retirement without the fear of losing affordable employer-based health coverage.
The ACA also encourages states to expand their Medicaid programs for low-income residents, bumping the income eligibility threshold to 133 percent of the federal poverty level. Maine is one of 22 states that have refused to make this change, but in the states that have expanded their programs, an estimated 4.4 million low-income people, including boomers, either have been newly enrolled in Medicaid or are now eligible for enrollment.
The future of Obamacare is uncertain, despite its growing influence on the nation’s health care system. The ACA faces a Supreme Court challenge over its subsidy system. Conservative lawmakers, intent on dismantling the law if they can’t repeal it, are working to overturn a tax on medical devices that provides essential funding. And, critically, many Americans feel the law is an overreach of federal authority.
Debate over the ACA has never really subsided, but it has become increasingly fractious in the leadup to the 2016 Presidential elections. You can bet the rhetoric will be flying in all directions as November draws near.