Signed into law on March 23, 2010, the Affordable Care Act (ACA) has proven to be consequential—and controversial. It survived multiple repeal efforts in 2017, including one the day after its last anniversary. And its positive impact on the health system has persisted, despite efforts by the Trump administration and Republican Congress to undermine the law and blame the results of those efforts on ObamaCare.
Below are eight commonly told myths about the law.
Myth #1: The ACA Has Driven Up Health Spending
Fact: The ACA Has Helped to Slow Growth in Health Spending
The law’s reduction of overpayments, promotion of value-based payments, and support for efficient delivery have contributed to a health care cost slow-down. Compared to prior decades, growth in health care costs has slowed by more than 50 percent per enrollee since the passage of the ACA.
Myth #2: The ACA Caused Skyrocketing Premiums
Fact: Trump Administration Actions Are Behind Premium Increases
Actions taken by the Trump administration, not ObamaCare, drove Health Insurance Marketplace premiums up for 2018. Without changes, Trump’s actions will do so again for 2019. These actions combined will add about 50 percent to premiums over two years.
Myth #3: ACA Hurts Middle-Income and Rural Americans
Fact: More Middle-Income and Rural Americans Are Insured Thanks to the ACA
The ACA’s coverage gains benefited virtually every group of Americans, including middle-income families, who previously couldn’t afford health insurance, and rural Americans. Since 2010, both groups have seen a 40-percent drop in the number of people uninsured.
Myth #4: ACA Has Priced Out Young Adults
Fact: Millions More Young People Now Have Health Insurance Because of the ACA
Through early 2016, the ACA contributed to 6.1 million more young adults gaining coverage. Even into 2017, the uninsured rate for young adults has remained at an historically low rate thanks largely to both the ACA’s extension of dependent coverage to young adults up to age 26 and its premium tax credits for coverage in the Health Insurance Marketplace. All told, ObamaCare has resulted in a 55 percent drop in the young adult uninsurance rate.
Myth #5: The Number of Uninsured Is Rising Because of the ACA
Fact: The Number of Uninsured Is Projected to Rise Because of Trump’s Actions
During the course of the first year of the Trump administration, the number of uninsured Americans began to rise, and is projected to jump 57 percent due to the repeal of the “individual mandate”—which requires you to have coverage if you can afford it—along with other changes.
Myth #6: ACA Has Not Improved Access to Care
Fact: On Many Measures, Access to Care Has Improved
A 2017 review found evidence of significant improvements in access to care and utilization associated with gaining coverage, such as increased outpatient utilization; greater rates of having a usual source of care and/or personal physician; increased preventive services use; increased prescription drug utilization and adherence; and improved access to surgical care.
Myth #7: People Do Not Like ACA Plans
Fact: People Do Like ACA Plans (and Satisfaction Is Growing)
Not only are people enrolled in Exchanges (Health Insurance Marketplaces) about as satisfied with their plans as those with employer coverage: satisfaction among adults with Marketplace or Medicaid coverage also rose between 2014 (78 percent) and 2017 (89 percent).
Myth #8: People Do Not Like the ACA
Fact: Support for the ACA Is at An All-Time High
Despite (and maybe because of) efforts to repeal it, the ACA has its highest level of public support—54 percent—since being enacted in March 2010.