How to improve your health care in the 21st century
A lot of people have heard of the Affordable Care Act (ACA).
They might also have heard that it has helped reduce the number of Americans who lack insurance.
But does it really do that much?
Here’s a look at some of the data that shows it does less to help people in poorer households, particularly those who are already struggling with health care costs.
What is the ACA?
The Affordable Care and Affordable Care Reconciliation Act (ACRA) was signed into law in 2010 by President Barack Obama.
The law requires states to provide insurance coverage for people who earn up to 138 percent of the federal poverty level (FPL), or about $14,400 for an individual in 2018.
It also gives states a broad set of flexibility in how they use the money, including how much to spend on preventive care.
It requires all states to establish a “health information exchange” to provide the same services to people who can’t get coverage through the Medicaid expansion program.
In addition, the ACA requires states and localities to provide health insurance to people earning up to 100 percent of FPL, or about a third of the poverty line.
That means, for example, people in the 20th percentile of the income distribution who don’t qualify for Medicaid are eligible for Medicaid coverage.
But even those who qualify for the federal Medicaid expansion are often ineligible for insurance through their own state, or are in an out-of-pocket financial hardship.
Medicaid also provides financial assistance to low-income adults, who make up about a quarter of the population.
So what’s the ACA really doing?
As the law is implemented, more than 40 million Americans have gained coverage.
Of those, about 23 million have gained insurance because of the ACA.
That’s up from about 12 million who gained coverage before the law took effect.
And that’s a significant increase: Since the law went into effect, the number getting coverage has increased by about 6 million, according to a Kaiser Family Foundation analysis.
But the rate of growth is still lower than the growth in coverage for the general population, which grew by a rate of 6.7 percent between 2014 and 2016.
Why are more Americans getting coverage?
The ACA has allowed many people who are not eligible for coverage under the Medicaid program to enroll in private insurance.
And while the ACA has helped some low- and middle-income Americans get insurance, that has also raised concerns about the long-term impact of the law.
A 2015 report by the Kaiser Family Affiliates found that by 2027, more Americans would have been uninsured than before the ACA, and that those with pre-existing conditions would be the most at risk for getting health insurance.
Those who have been able to get insurance but not yet found coverage could be worse off than before.
In 2018, the percentage of people who reported they could not afford health insurance went up by 17 percentage points among low- to moderate-income households, according the Kaiser report.
That increase was driven by a rise in the uninsured rate for young adults, a group with high levels of household income.
Among those under age 30, the uninsured rates went up from 23.5 percent in 2016 to 26.6 percent in 2018, according a study by the Urban Institute.
In 2016, only about 15 percent of Americans under age 65 had health insurance, according another study by researchers at the Urban University.
The ACA also made insurance available to children, who are more likely to be low- or moderate- income and are often more likely than their parents to not have coverage through their employer.
In 2017, the Centers for Medicare and Medicaid Services released a report that found that the percentage that could not obtain insurance for any reason went up in 2020 by about a fifth.
About 15 percent more children under age 19 said they could get insurance in 2020 than in 2016.
That number rose from 12.5 million to 13.1 million.
That report found that about 5 million more children would be uninsured in 2020 compared to 2016, and 1.3 million fewer adults under age 25.
But not everyone is seeing benefits.
Some of the uninsured are children who are too young to get health insurance under the ACA’s Children’s Health Insurance Program (CHIP), which is administered by the federal government.
This program was expanded in 2020 under the law, and its expansion was largely responsible for the rise in uninsured rates, according an analysis by the nonpartisan Kaiser Family Foundations.
The CHIP expansion expanded Medicaid coverage for families earning up from $12,600 to $64,000, and also expanded Medicaid to people with incomes between $16,000 and $64 and to adults making up to 400 percent of poverty.
Medicaid has been available to people on food stamps for years.
But some states have decided that people with preterm births, children with disabilities, and people with HIV/AIDS should not be able to participate in CHIP because of their risk of financial