Eleven years ago Sunday, I made my debut post here writing about all the ways the ACA would help people right away. Those were important, but not nearly as important as what happened when the full act kicked in on January 1, 2014. Since then, millions have insurance and lives saved.
Here's Laura Packard, a young cancer survivor who would not have had access to healthcare without the Affordable Care Act.
"This is personal to me because the Affordable Care Act saved my life," Packard wrote in USAToday. "As a small business owner, my insurance is through the ACA. When I was diagnosed with stage 4 cancer four years ago, my policy picked up the half-million dollar price tag it took to keep me alive, get me through six months of chemotherapy and a month of radiation treatments. Today I’m in remission."
I can testify, not only because I and other family members were able to get life-saving access to healthcare through the exchanges, but also because pre-existing conditions are now a thing of the past. If you're sick, you get treatment. No fights over whether your particular condition is something insurers have to cover.
Still, there have been problems, and one of the biggest one has been the rising costs of deductibles, copayments and inadequate subsidies for premiums. If you have never seen what the "400 percent cliff" looks like, let me tell you that it isn't pretty. I have seen situations where people age 60 were receiving subsidies for their premiums and ended up earning more than 400 percent of the poverty level, causing them to owe tens of thousands back to the government. That provision was a disaster, but at least for now, it's been repaired.
The American Rescue Act limits payments for premiums to a maximum of 8.5 percent of income, even when the total is over 400 percent of the poverty level. It increases subsidies for people in the 150-400 percent range and limits the maximum they pay for insurance. If anyone is on unemployment, their subsidy automatically goes to the maximum amount.
These provisions are exactly what the doctor ordered, but there's a catch: They expire at the end of 2022. President Biden wants them to be made permanent, but that will have to happen outside of the reconciliation process and emergency legislation that the American Rescue Plan is.
The ACA is here to stay. The only question is whether the will exists to make it better. There's just one guarantee right now that I can see: Healthcare will absolutely be on the ballot in 2022, and Republicans will (once again) be on the wrong side of the debate.