Affordable Care Act Turns Three: Some Facts and Figures

  • The ACA is three years old; the Affordable Care Act (ACA) was signed into law on March 22, 2010
  • 3.1 million young adults have been able to remain on their parents’ insurance policies until age 26 due to ACA protections
  • Nearly 71 million Americans have expanded access to preventive services at no cost under ACA
  • October 1, 2013, is the date that uninsured Americans can sign up for insurance at a marketplace; information is already available at
  • 21 pages are in the ACA application for insurance coverage and subsidies; proponents of the law are pressing for application simplification
  • Two-thirds of Americans say they don’t know enough about the ACA to judge how it will affect them (March 2013 poll of the Kaiser Family Foundation)

ACA: Behind The Numbers

It is only six months until the health insurance marketplaces authorized by the ACA are to be operational and nine months before insurance coverage is required.  What is happening to ensure that the marketplaces work and uninsured and underinsured Americans can consider purchasing insurance through the marketplaces and receiving premium subsidies if eligible for them?

After passage of the ACA, the Obama Administration encouraged all states to build and operate their own insurance marketplaces.  In the years since enactment, only 17 states and the District of Columbia have chosen to operate their own marketplaces.  Seven more will share responsibilities for their marketplaces with the federal government.  More than have of the states – 26 – will be part of the federal  marketplace.

The Obama Administration has also offered final guidance on the benefits that the health insurance plans offered through the marketplaces must contain.  The final guidance addressed some – but not all – of the concerns of consumers about the adequacy of the benefits of “marketplace plans.”  Health insurance issuers will make determinations by the end of March 2013 about the specific plans they will offer through the marketplaces.  Those decisions will in turn permit consumers and consumer organizations to assess the quality of insurance offerings.

In the summer of 2013, the Obama Administration will begin a campaign to make the public aware of insurance enrollment opportunities through the marketplaces.  A coalition of consumer and advocacy groups – Enroll America – has already begun a wide range of activities to prepare consumers for insurance enrollment, improve education about the marketplaces, and develop consumer-friendly systems for enrollment.

In the months since the Supreme Court decision on the ACA and the Court’s determination that states could not be required to expand their Medicaid programs, some states have shown considerable indecision about their Medicaid plans.  In recent days, the Obama Administration has apparently given tentative approval to the state of Arkansas to expand insurance coverage to the Medicaid population through the private insurance market instead of through the Medicaid program.   In the few days since this news was published, additional states have signaled that they will consider the private insurance option for their Medicaid population.  The outcome of the state deliberations and the Obama Administration position on those plans are unclear at this date.