Passed in 2010, the Patient Protection and Affordable Care Act (sometimes referred to as the PPACA, ACA, or "Obamacare") is a comprehensive health reform law designed to address pertinent issues in healthcare such as affordability, quality, and workforce development. It's had a history of success in expanding access to healthcare, which, in turn, improves health for Americans.
However, despite its success and consistent support from public polling, the ACA has faced strong opposition from pharmaceutical corporations and Republican lawmakers. Now, amid the coronavirus pandemic that's forcing millions of Americans away from their jobs and into hospital beds, the federal government is attempting to overturn the ACA in its entirety.
This challenge is based on the argument that if certain tenets have been struck down, the entire reform law should be abandoned. Such an argument is reductionist and needlessly catastrophic to our health system.
Why does this matter to college students? Beyond the ACA's politicization and policy nuances, the legislation carries key provisions and consequences to every population and every age group. Here are four reasons young adults benefit from and should vote to protect the Affordable Care Act.
If you're under 26, you probably haven't yet had to worry about enrolling in an insurance plan. That's because the ACA allows most citizens to stay on a parent's healthcare plan as a dependent until they're 26. This stands for both employer-sponsored health insurance (ESHI) and plans bought through Health Insurance Marketplaces.
Health Insurance Marketplaces are one of the ACA's most successful tools for increasing the amount of Americans covered by health insurance. Here, you can purchase coverage individually or for your family; this allows you to bypass the typical employer-sponsored insurance structure (which involves group purchasing).
The ACA also introduced student healthcare plans and expanded the Medicaid program to further diversify your choice of coverage.
All Marketplace health plans and many outside plans are required to provide preventive care without charging copays or coinsurance. Examples of these services include:
- Blood pressure and cholesterol screenings to maintain cardiovascular health
- Immunizations for more than a dozen viruses and STDs
- Counseling for dieting, obesity, alcohol misuse, and tobacco use
- Screenings for STDs like Hepatitis B, Hepatitis C, and HIV
The importance of preventive care can't be overstated. Obviously, chronic disease reflects a person's deteriorating health, but it's also egregiously costly: a 2019 CDC study found that approximately one-fifth of the U.S. economy is dedicated to treating and addressing the consequences of chronic disease. Rather than spending thousands of dollars to treat a chronic disease, investing in your preventive care will help you avoid disease.
The health insurance industry strives to find the healthiest, most low-risk consumers, because they're less likely to frequently occur large medical bills. Historically, this meant that consumers with pre-existing health conditions that increase your need for medical care would face impossibly high premiums or would be denied coverage.
Under the ACA, "no insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started." Nor can insurance plans raise your rates after enrollment based only on your health status.
What are pre-existing conditions? Any health condition, really; asthma, diabetes, cancer, and pregnancy are all examples. Young adults aren't immune from these conditions, but the ACA protects insurance companies from exploiting that.
If you grew up with a regular primary care doctor, where you'd get a yearly physical and you'd get prescriptions to fight your flu, you're familiar with the idea of having a single doctor. One problem that undercut the healthcare system for decades was an insurance company's ability to restrict which doctors you were able to visit.
Now, the ACA guarantees your freedom to choose the doctors that provide your health services. It also removes the requirement to get a PCP referral to visit an OB-GYN.
One of the most important restrictions the ACA lifts is the mandate against visiting out-of-network emergency rooms. If you break your leg while you're on a college campus, good news: you're now safe to go straight to the ER without having to wait for insurance approval, and you can't be overcharged for those services.