Trust for America's Health Urges Congress to
Protect the Act's Key Provisions
WASHINGTON, March 28,
2024 /PRNewswire/ -- This year marks the
14th anniversary of the enactment of the Affordable Care
Act (ACA). Its passage was the most significant advancement of
health policy since the establishment of Medicare and Medicaid in
the 1960s and made healthcare accessible and affordable for
millions more Americans. Despite efforts to repeal and restrict the
ACA, the progress the legislation has made toward health equity and
improving public health prevention is significant and lifesaving.
It must be preserved.
The ACA was signed into law in March
2010 during the 110th Congress. Some of the major
provisions of the legislation include the creation of a public
marketplace for health insurance, expansion of Medicaid eligibility
to many adults with low incomes, coverage of recommended preventive
services, and the establishment of the Prevention and Public Health
Fund.
In the decade leading up to the ACA's passage, the percentage of
people without health insurance steadily increased, reaching over
16 percent of all U.S. residents in 2010, according to the U.S.
Census Bureau. Preventive services such as mammograms and other
cancer screenings, diabetes screenings, and vaccinations were a
costly expense and not easily accessible for a significant number
of Americans.
Health insurance enrollment has soared in the years since the
Affordable Care Act became law. Forty states and D.C. have expanded
Medicaid. As a result, many of those states saw a significant
decrease in the share of people without insurance. Nationally, the
percentage of uninsured adults between 18-65 steadily decreased to
12.2 percent in 2022, according to the Centers for Disease Control
and Prevention. Uninsurance rates also dropped significantly for
Black, Latino, and Asian Americans, and for households with
lower-incomes.
Medicaid expansion has had significant benefits related to
greater health insurance coverage. Mortality rates declined in
states that expanded Medicaid eligibility to more adults with low
incomes, according to a 2021 study (using data from before COVID-19
was declared a public health emergency). Expansion has contributed
to healthcare affordability, access and utilization of care,
financial security, and positive impacts on state
economies.
Additionally, the ACA ensured access to vital preventive care
and screenings without a copay. Prior to the ACA, many health plans
failed to cover preventive services, and those that did often
required individuals to pay a share of the costs. Even small
out-of-pocket payments have been shown to deter people from
accessing preventive services, particularly people with lower
incomes.
The creation of the Prevention and Public Health Fund (PPHF) has
been an important tool for improving health outcomes and reducing
health expenditures. To date, PPHF has provided over $12 billion to states and territories to expand
access to immunizations, strengthen detection of diseases, and
prevent chronic diseases. One program supported by PPHF, the Tips
from Former Smokers Campaign, has helped one million smokers quit
for good, preventing an estimated 129,000 early deaths.
Yet, the ACA's progress continues to be at risk.
Ten states have yet to expand Medicaid eligibility. And the
current unwinding of continuous Medicaid enrollment that was
authorized during the COVID-19 public health emergency has left
many individuals and families without health coverage.
Litigation currently moving through the courts threatens access
to preventive services. TFAH joined other public health
organizations and scholars in an amicus brief describing the
potential harms of overturning ACA's preventive services coverage
requirements. Should the courts overturn part or all of this
important protection, millions of Americans could lose access to
these life-saving services.
An additional threat to the ACA's impact is the use of monies
that should be directed to the Prevention and Public Health Fund to
other legislation or priorities. To date, nearly $13 billion has been redirected in this manner.
Most recently, the proposed costs in the Protecting Health Care for
All Patients Act of 2023 were offset by taking more than
$1 billion from PPHF. TFAH was joined
by more than 100 organizations in a letter opposing these
cuts.
TFAH will continue to urge Congress to restore funding for the
Prevention and Public Health Fund and protect access to preventive
services.
"The ACA is a critical catalyst toward the goal of ensuring the
opportunity for optimal health for everyone. It has unlocked access
to healthcare including preventive services for so many in this
country, including those at the highest risk of poor health. We
can't afford to turn back," said J. Nadine
Gracia, president and CEO of Trust for America's Health.
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SOURCE Trust for America's Health