Despite Attacks, the ACA Has Delivered on Its Promise to Millions of Americans

In the nine years the Affordable Care Act has been law, millions of Americans have benefited both directly and indirectly. Despite this success, the Trump administration and Department of Justice want the federal courts to overturn the ACA in its entirety, alarming his own party, which has no replacement plan for the millions who would lose coverage from ACA repeal.

Since the ACA was implemented, 20 million Americans have gained access to health insurance. Many more — including millions of patients in Medicare — now receive preventative care at no cost, paving the way for a healthier future and lower costs in the health system.

Young people pursuing their education and career goals have been able to stay on their parents’ insurance plans until they turn 26. Because of protections included in the ACA, 130 million Americans with pre-existing conditions, who in the past would have been denied coverage or priced out with sky-high premiums, have health insurance — including millions of children.

Whether your child has a peanut allergy, asthma or a rare genetic disorder like Courtney Koslow and Maura Vogel’s daughter Mae, the ACA ensures that insurers cannot deny treatment for any pre-existing condition. Mae was born with Childhood Interstitial Lung Disease, a condition that prevented her from breathing since birth.

Thanks to the ACA’s consumer protections that ended lifetime caps and limits on coverage, insurance picked up the cost of an expensive 20-month hospital stay and ensured she could get subsequent treatment as she developed and grew without being charged more for a pre-existing condition. Before the ACA, Mae’s family would have hit the $1 million cap on coverage after the first three months and been forced into debt or bankruptcy for the same care.

The impact of the ACA has been especially dramatic for women, requiring insurance companies to cover a package of essential health benefits that includes basic services such as maternity care, mental health and prescriptions that many plans omitted before the law’s passage. Fifty-five million women now enjoy guaranteed coverage for birth control and maternity care in their health plans.

More than half of all women and girls qualify as having pre-existing conditions. Prior to the ACA, these women who had experienced common health conditions such as pregnancy or endometriosis were at risk of being charged dramatically more than men for the same plans. The ACA banned that discriminatory practice.

Under the ACA, more than three dozen states and the District of Columbia have expanded Medicaid — delivering on the promise of affordable and accessible health care for those who need it most, including seniors, people with disabilities, and children. This increased access to care has been especially important in communities struggling to address the opioid crisis, in rural communities and for low-wage workers.

In Ohio, a state devastated by the opioid epidemic, recovering heroin addict Phillip Kraus credits the ACA with saving his life and putting him on the path to recovery at last. Kraus went without treatment for years until Ohio expanded Medicaid, allowing him to get into a 28-day treatment program that helped him kick the addiction and get his life back on track.

For millions of Americans with similar stories, the ACA isn’t some political game. It’s a lifeline.

But President Donald Trump isn’t listening to those stories. While polls continue to show most Americans want to improve and expand health care, his administration continues sabotaging the hard-won protections Americans enjoy under the ACA. Having failed again and again in Congress, Trump is trying to sidestep the legislative process and dismantle the law piece by piece through administrative action.

Trump issued an executive order that expands the availability of junk insurance plans and a rule designed to undermine the ACA’s contraceptive coverage mandate, putting millions of women in jeopardy — including those who depend on birth control to manage painful health conditions. A federal court just ruled against Trump’s association health plans rule because it circumvents ACA rules, undermines ACA marketplaces and violates the Employee Retirement Income Security Act rules.

At the same time, the results of the 2018 midterm elections made it clear voters are looking for leaders committed to preserving and strengthening the ACA, not undermining it. Unfortunately, Trump doesn’t care: His recent federal budget proposal again includes repeal of the ACA and more than $1.5 trillion in cuts to Medicaid over 10 years.

While the GOP is stuck trying to re-create the past, the new Democratic majority in Congress is building on the success of the ACA with everything from bills to address Trump’s sabotage, to prescription drug reforms, to a range of proposals that would give patients a public option and Rep. Pramila Jayapal’s transformative “Medicare-for-all” bill.


Margarida Jorge is executive director of Health Care For America Now — the national grassroots coalition that ran a $60 million campaign to pass and protect the ACA.

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