ACA Provides Healthcare Coverage to 31 Million Americans

June 23, 2021 by Alec Stone MA, MPA, Former ONS Director of Government Affairs and Advocacy

Approximately 31 million Americans now have healthcare coverage (https://aspe.hhs.gov/system/files/pdf/265671/ASPE%20Issue%20Brief-ACA-Related%20Coverage%20by%20State.pdf) through the Affordable Care Act (https://www.hhs.gov/healthcare/about-the-aca/index.html) (ACA), according to a June 2021 issue brief (https://aspe.hhs.gov/system/files/pdf/265671/ASPE%20Issue%20Brief-ACA-Related%20Coverage%20by%20State.pdf) from the office of the assistant secretary for planning and evaluation (https://aspe.hhs.gov/) (ASPE). Of those, 11.3 million consumers were enrolled in Marketplace (https://www.healthcare.gov/quick-guide/getting-marketplace-health-insurance/) plans, 14.8 million people were newly enrolled in Medicaid, 1 million individuals were enrolled in ACA’s Basic Health Program (https://www.medicaid.gov/basic-health-program/index.html) option, and nearly 4 million previously eligible adults gained coverage under the Medicaid expansion due to enhanced outreach and increased federal funding. Additionally, insurance rates have fallen across the country since the law’s implementation 11 years ago.

The numbers were based on enrollment data (https://aspe.hhs.gov/system/files/pdf/265671/ASPE%20Issue%20Brief-ACA-Related%20Coverage%20by%20State.pdf) from late 2020 and early 2021, with ACA expanding coverage to Americans through two main pathways: providing tax credits to consumers with incomes between 100% and 400% of the federal poverty level and expanding Medicaid eligibility in participating states.

ASPE (https://aspe.hhs.gov/system/files/pdf/265671/ASPE%20Issue%20Brief-ACA-Related%20Coverage%20by%20State.pdf) reported that from 2010–2016, the number of nonelderly uninsured adults decreased by 41%, falling from 48.2 million to 28.2 million. At the close of 2020, an estimated 14.8 million newly eligible adults were enrolled in Medicaid coverage through the adult group bracted by the ACA expansion. An additional estimated 3.9 million people (https://aspe.hhs.gov/system/files/pdf/265671/ASPE%20Issue%20Brief-ACA-Related%20Coverage%20by%20State.pdf) were enrolled in the Medicaid expansion adult group under the ACA who would have been eligible for Medicaid before the ACA. Currently, 37 states and the District of Columbia (https://aspe.hhs.gov/system/files/pdf/265671/ASPE%20Issue%20Brief-ACA-Related%20Coverage%20by%20State.pdf) have adopted the ACA Medicaid expansion of coverage to adults.

“Healthcare coverage is life-changing for our communities and families. Thanks to ACA (https://www.hhs.gov/healthcare/about-the-aca/index.html), millions of Americans have been able to enroll in high-quality, affordable coverage through the Marketplaces and Medicaid expansion,” said (https://www.cms.gov/newsroom/press-releases/new-hhs-data-show-more-americans-ever-have-health-coverage-through-affordable-care-act) CMS Administrator Chiquita Brooks-LaSure. “The Biden-Harris administration is working to strengthen these vital programs that have advanced health equity and improved health outcomes. With the implementation of the American Rescue Plan (https://www.whitehouse.gov/american-rescue-plan/), which builds on ACA, health coverage is more affordable and accessible than ever. As we rebuild from the health and economic impacts of the pandemic and work to address the disparities it has illuminated, we’ll protect and build on ACA to ensure Americans can access the care they need.”

ONS advocates for all individuals to have access to health insurance coverage. Although the numbers are showing a promising increase in the number of covered Americans, not everyone has access to coverage and benefits. ONS’s mission is to provide quality cancer care (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/access-quality-cancer) for all patients, and ensuring that Americans are insured is a critical part of that care.


Copyright © 2021 by the Oncology Nursing Society. User has permission to print one copy for personal or unit-based educational use. Contact pubpermissions@ons.org for quantity reprints.