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ashoup
In Fact Sheet, Research

FACT SHEET: The Affordable Care Act Has Expanded Access to Care for People of Color

Over the last 14 years, the Affordable Care Act (ACA) has helped tens of millions of Americans gain access to affordable health coverage. Thanks to President Biden’s efforts to lower the cost of health care, a record-breaking 21.3 million Americans signed up for coverage through the Marketplaces for 2024. The Inflation Reduction Act lowered premiums for people who buy their own coverage by an average of $2,400 a year per family.

The ACA has survived countless repeal attempts and now it’s stronger than ever. Yet Republicans still want to destroy the ACA and all of its protections for over 100 million people with pre-existing conditions. Donald Trump has fully reignited his calls to repeal the ACA. As Trump is escalating his threat, Republicans in Congress and their allies are working overtime to dismantle reproductive care and access to vital preventive care, hike premiums, slash Medicare and Medicaid, reverse recent coverage gains, and raise prescription drug costs for the American people. 

This week, Protect Our Care is highlighting five key ways the ACA is working across the nation: 

Monday, March 18: How the ACA helps women
Tuesday, March 19: How the ACA helps seniors & young people
Wednesday, March 20: How the ACA helps people with pre-existing conditions
Thursday, March 21: How the ACA helps people of color
Friday, March 22: How the ACA expanded affordable coverage to tens of millions of Americans

Background:

There is overwhelming evidence that the ACA has made a historic contribution to improving health care for communities of color. In addition to increasing coverage and improving health outcomes, the health care law has helped narrow racial disparities in maternal health, cancer care, and more. Even as the ACA is more popular than ever, Republicans are still trying to repeal and sabotage the health care law.  Meanwhile, Democrats continue their work to lower costs and expand affordable coverage. Democrats’ policies to lower costs are an essential step in reducing ethnic and racial inequities in health care, as research shows better access to care as well as a more diverse health care workforce – two goals advanced by the ACA – improve health outcomes.

By the Numbers:

  • The uninsured rate among nonelderly Black and Hispanic/Latino young adults between 2010 and 2022 was cut in half from 19.9 percent to 10 percent and 32.6 percent to 18 percent respectively.
  • American Indians and Alaskan Natives saw both private and public health insurance enrollment increase by 1.2 percent and 3.2 percent respectively after the implementation of the ACA with an additional 6.3 percent increase in public insurance enrollment in Medicaid expansion states.
  • Medicaid expansion has reduced racial disparities in timely treatment with one study showing its introduction in states completely erases disparities in timely cancer care.
  • Although less directly researched, the ACA has also empirically benefited first-generation immigrants with one study showing post-ACA that the rates of insurance increase for Latino and Asian immigrants by 14.3 percent and 9.9 percent respectively in just the state of California.
  • Black and Hispanic individuals are 59.2 percent more likely to have gained health coverage due directly to the expanded premium subsidies than White individuals in non-expansion states.

Lowering the Uninsured Rate. Before the passage of the ACA, more than 16 percent of the nearly 50 million Americans lacking health insurance were African Americans. According to the Kaiser Family Foundation, the ACA helped lower the uninsured rate for nonelderly African Americans by nearly half between 2010 and 2022 from 19.9 percent to 10 percent. The percentage of people gaining health insurance under the ACA was higher for Latinos than for any other racial or ethnic group in the country. According to a study from Families USA, 5.4 million Latinos would lose coverage if the health care law were overturned. Research also shows the ACA cut uninsurance rates among Asian Americans by more than half–from nearly 20 percent to just under 8 percent — eliminating coverage disparities with white Americans.

Reductions in Racial Disparities In Health Outcomes. Access to preventive care starts with access to affordable coverage. The ACA led to historic reductions in racial disparities in access to health care, but racial gaps in insurance coverage narrowed the most in states that adopted Medicaid expansion. The ACA significantly reduced racial disparities in the share of people who went without care because of cost. Positive medical outcomes have also increased significantly with one study showing Black heart transplant recipients had a 8 percent increase in post-surgery survival after the passage of the ACA.

Improvements To Infant And Maternal Health. Whether coverage comes from Medicaid expansion or increased access to affordable coverage on the ACA Marketplace, coverage improves infant and maternal mortality outcomes. One study found that reductions in maternal mortality in expansion states were concentrated among Black mothers, “suggesting that expansion could be contributing to decreasing racial disparities in maternal mortality.” Expansion has also been tied to improving health outcomes for Black babies, significantly reducing racial disparities in low birth weight and premature birth. 

Preventive Care Leads To Improvements In Disease-Specific Diagnosis And Treatment. A 2017 study called preventive care “one of the most important health care strategies to facilitate early diagnosis and treatment, improve quality of life, and prevent premature death.” Access to preventive care through Medicaid expansion reduced racial disparities in cancer care and resulted in earlier diagnosis and treatment for Black patients. According to the Center for American Progress, Black women were more likely to receive care because of the ACA.

ashoup
In Fact Sheet, Research

FACT SHEET: Republicans Propose Budget That Will Raise Health Care Costs and Rip Coverage Away from Millions of Americans

In MAGA Republicans’ latest attack on American health care, the Republican Study Committee (RSC) released a disastrous budget proposal for FY2025. The plan would increase prescription drugs prices by repealing the Inflation Reduction Act, hike annual premiums by thousands of dollars, expand junk plans that don’t cover basic benefits like prescription drugs or maternity care, strip away protections for people with pre-existing conditions, and put Medicaid coverage for millions in jeopardy. 

While President Biden and Democrats in Congress are hard at work bringing down the cost of health care in order to keep food on the table and a roof over the heads of millions of people, MAGA Republicans are working to rip away protections, raise health care costs, and throw the health care system into chaos. Here’s just a few of the catastrophic changes Republicans want: 

Kill the Inflation Reduction Act’s Drug Pricing Savings. The RSC budget proposal would fully repeal the Inflation Reduction Act, which is saving Americans thousands of dollars on health care by holding big pharmaceutical companies accountable and bringing down the cost of prescription drugs, making health care plans more affordable with premium tax credit subsidies, and capping the price of insulin at $35 per month for Medicare Part D beneficiaries. Here are just a few of the impacts this disastrous plan would have on American health care:

  • GONE: Insulin co-pays will no longer be capped at $35 per month for 4 million Americans on Medicare who use insulin.
  • GONE: 52 million Medicare beneficiaries will no longer be able to receive the shingles vaccination and other recommended vaccinations free of cost.
  • GONE: Seniors on Medicare will no longer be protected from drug company price hikes through inflation rebates.
  • GONE: Medicare will be banned from negotiating drug prices. Nearly 9 million people take the first ten drugs that were selected for Medicare negotiation, which account for 20 percent of the annual Medicare Part D spending. Negotiated prices will take effect in 2026.
  • GONE: 400,000 low-income seniors will no longer receive more help affording prescription drugs through the Medicare Part D Extra Help program.
  • GONE: Medicaid and CHIP beneficiaries will no longer have access to recommended vaccinations free of cost.
  • GONE: Seniors with the highest brand-name drug costs will no longer have their out-of-pocket costs capped at $3,250 for the year and $2,000 in 2025, which would save nearly 19 million Americans an average of $400 each year

Strike Premium Tax Credits, Raising Premiums By Thousands of Dollars. The RSC budget proposal would rescind temporary enhancements to premium tax credits originally enacted in the American Rescue Plan and extended by the Inflation Reduction Act until 2025. These enhanced tax credits have reduced ACA Marketplace enrollees’ premiums by an average of $800 per year.

  • GONE: Premium tax credits that make premiums affordable for 80 percent of people who purchase health care on the Marketplace, saving millions of Americans an average $527.
  • GONE: Annual health insurance premiums will increase by an average $7,676 for a family of four making $125,000 a year if premium tax credit enhancements are rescinded.

Expand Junk Plans. The RSC proposal would codify rules put forth by the Trump administration that expanded health insurance plans known as association health plans (AHPs). These plans are not required to cover the essential health benefits put in place by the Affordable Care Act and are allowed to charge people more based on their age, health status, and gender. AHPs have a long history of fraud and unpaid claims and provide weaker cost and protection coverage. The proposal also applauds efforts by the Trump administration to expand short-term limited-duration plans, which engage in predatory marketing practices, fail to protect people with pre-existing conditions, and put patients at risk of bankruptcy when they get sick. The Trump administration’s decision to expand access to these plans exposed consumers to scams and reduced transparency about coverage limits and hidden fees. 

Rip Away the ACA’s Protections For Pre-Existing Conditions. The RSC proposal would remove many protections for the over 100 million Americans with pre-existing conditions made possible through the Affordable Care Act, and would allow insurers to deny coverage, except for people who have had continuous coverage through an employer or the individual market.

Threaten Coverage For People With High-Risk Medical Conditions, Leaving Millions of Americans At The Mercy of State Coverage Pools. The RSC proposal would funnel people with high-risk medical conditions into state-run coverage pools, leaving states with the final say on how insurers can determine premiums based on health risks. These high risk coverage pools often impose high premiums and deductibles, with premiums as much as 200 percent higher than average and deductibles substantially greater than allowed under the ACA – all at a higher cost to American taxpayers. Numerous studies have shown that high risk coverage pools often provide worse care, with many having exclusions for pre-existing conditions, limited benefits, lifetime and annual limits on coverage, waiting periods, and often result in delayed or forgone care.

Loosen Restrictions For Hospitals Providing Worse Care At Higher Costs For Patients. The RSC proposal would eliminate the ban on physician-owned hospitals, which provide limited or no emergency services, cherry-pick the most potentially profitable patients, and incur significantly higher costs on the Medicare program. According to the HHS, up to one-third of these hospitals may violate Medicare requirements by relying on publicly funded services to stabilize patients while still charging the patients exorbitantly.

Jeopardize Medicaid Coverage For Millions Through Block Grants. MAGA Republicans want to radically restructure Medicaid by changing it into five block grants. Block grants would shift costs to states and inevitably result in deep cuts to Medicaid programs by capping the amount of federal Medicaid funding states receive. As CBPP found in 2017, a block grant would force states to make deep cuts to their Medicaid programs to compensate for the federal funding cuts.

ashoup
In Fact Sheet, Research

FACT SHEET: The Affordable Care Act Has Lowered Costs and Protected Patients With Pre-Existing Conditions From Being Denied Coverage

Over the last 14 years, the ACA has helped tens of millions of Americans gain access to affordable health coverage. Thanks to President Biden’s efforts to lower the cost of health care, a record-breaking 21.3 million Americans signed up for coverage through the Marketplaces for 2024. The Inflation Reduction Act lowered premiums for people who buy their own coverage by an average of $2,400 a year per family.

The ACA has survived countless repeal attempts and now it’s stronger than ever. Yet Republicans still want to destroy the ACA and all of its protections for over 100 million people with pre-existing conditions. Donald Trump has fully reignited his calls to repeal the ACA. As Trump is escalating his threat, Republicans in Congress and their allies are working overtime to dismantle reproductive care and access to vital preventive care, hike premiums, slash Medicare and Medicaid, reverse recent coverage gains, and raise prescription drug costs for the American people. Additionally, Republican allies in the courts are attacking access to free preventive services under the ACA, jeopardizing lifesaving care for millions. Read more about the case here. 

This week, Protect Our Care is highlighting five key ways the ACA is working across the nation: 

Monday, March 18: How the ACA helps women
Tuesday, March 19: How the ACA helps seniors & young people
Wednesday, March 20: How the ACA helps people with pre-existing conditions
Thursday, March 21: How the ACA helps people of color
Friday, March 22: How the ACA expanded affordable coverage to tens of millions of Americans

Background:

Prior to the passage of the ACA, people with pre-existing conditions could be charged more, denied coverage, or denied certain benefits simply for having a diagnosis ranging from specific conditions like cancer, diabetes, or pediatric asthma, or simply for being a woman. Without the ACA, a change in life circumstances, such as changing jobs, getting divorced, or retiring could mean losing access to lifesaving health care for the over 100 million Americans with pre-existing conditions.

Republicans in Congress are working to dismantle protections for pre-existing conditions. Under the guise of offering cheaper insurance, MAGA-Trump Republicans want to expand the availability of short-term “junk plans” and association health plans that don’t cover basic benefits like prescription drugs or maternity care and can drop and deny coverage for people with pre-existing conditions. The GOP also wants to cut funding for Medicaid and kick people off the program by imposing burdensome paperwork requirements. All of these actions would be devastating for the tens of millions of Americans who rely on the ACA’s protections to access affordable health care. 

A Closer Look:

  • Over 100 million people with pre-existing conditions are protected from being charged more for, dropped from, or denied health coverage. 
  • 179 million Americans with employer coverage are protected from lifetime and annual limits, in addition to over 20 million with ACA Marketplace coverage. 
  • Insurers can no longer charge women more than men for the same coverage and are required to cover important health benefits like maternity care.
  • Health insurance companies can not discriminate by charging more or denying coverage based on sexual orientation or gender identity. 

Thanks to the ACA:

Over 100 Million Americans With Pre-Existing Conditions Are Protected. Because of the ACA, insurers in the individual market can no longer drop or deny coverage, or charge more because of a pre-existing condition. Over 100 million Americans have a pre-existing health condition, including nearly 30 million Americans with diabetes, 26 million with asthma, and millions more with cancer, arthritis, and heart disease.

The ACA Guarantees Comprehensive Coverage. Because of the ACA, insurers have to cover what are known as “essential health benefits,” such as maternity care, prescription drugs, and substance and mental health. Before the ACA, individual market plans often failed to cover these basic, and oftentimes preventive, health services. 

The ACA Ended Annual And Lifetime Limits, Including For People With Employer-Based Coverage. Thanks to the ACA, insurers can no longer put annual or lifetime limits on the care you receive. At the time the ACA was passed, 91 million Americans had health care through their employers that imposed lifetime limits. Many such plans capped benefits at $1 million, functionally locking people with complex medical needs out of coverage. 179 million Americans with employer coverage are protected from lifetime limits, in addition to the millions with ACA Marketplace coverage. 

Women Can No Longer Be Charged More Than Men. Because of the ACA, insurers can no longer charge women more than men for the same coverage, and insurers are now required to cover important health benefits like maternity care. Before the ACA, only 12 percent of individual market plans offered maternity care. The ACA established maternity coverage as one of the ten essential health benefits required on all new individual and small group policies. President Biden’s American Rescue Plan expanded on this by creating an incentive for states to offer a full year of Medicaid coverage postpartum instead of the required 60 days, and 46 states and DC have done so. 

LGBTQI+ Americans Are Protected From Discrimination By Health Insurance Companies. Republicans have worked to sabotage the Biden administration’s efforts to require health insurance plans offered through the ACA to include sexual orientation and gender identity as protected characteristics. LGBTQI+ Americans are more likely to be without health insurance than straight individuals. According to a Center for American Progress survey, in 2019, the LGBTQI+ uninsured rate was 20 percent in holdout states, compared to 8 percent in states that adopted Medicaid expansion. Access to affordable, quality health care plans under the ACA help combat the number of LGBTQI+ Americans who are uninsured. Premium subsidies made available by the American Rescue Plan and extended by the Inflation Reduction Act have helped nearly 210,000 LGBTQI+ enrollees have access to zero-premium plans.

ashoup
In Fact Sheet, Research

FACT SHEET: The Affordable Care Act Has Lowered Costs and Improved Health Care for Children and Young People

Protect Our Care Is Marking the 14th Anniversary of the Affordable Care Act With 5 Days Celebrating the Growing Success of the Health Care Law Under President Biden

Over the last 14 years, the Affordable Care Act (ACA) has become an essential pillar of the American health care system and has helped tens of millions of Americans gain access to affordable health coverage. Thanks to President Biden’s efforts to lower the cost of health care by expanding the ACA, a record-breaking 21.3 million Americans signed up for coverage through the Marketplaces for 2024. The Inflation Reduction Act lowered premiums for people who buy their own coverage. Four out of five individuals can find coverage on the Marketplace for under $10 per month.

The ACA has survived countless repeal attempts, and now it’s stronger than ever. Yet Republicans still want to destroy the ACA and all of its protections for children and young adults. Donald Trump has fully reignited his calls to repeal the ACA. As Trump is escalating these threats, Republicans in Congress and their allies are working overtime to dismantle access to reproductive care and vital preventive care, hike premiums, slash Medicare and Medicaid, reverse recent coverage gains, and raise prescription drug costs for the American people. Additionally, Republican allies in the courts are attacking access to free preventive services under the ACA, jeopardizing lifesaving care for millions. Read more about the case here. 

This week, Protect Our Care is highlighting five key ways the ACA is working across the nation: 

Monday, March 18: How the ACA helps women
Tuesday, March 19: How the ACA helps seniors & young people
Wednesday, March 20: How the ACA helps people with pre-existing conditions
Thursday, March 21: How the ACA helps people of color
Friday, March 22: How the ACA expanded affordable coverage to tens of millions of Americans

Background:

Before the passage of the ACA, young Americans could be thrown off their parent’s health insurance the moment they turned 18. Many young adults were left uninsured after graduating college and were forced to navigate adulthood with entry-level or part-time jobs that didn’t offer employer-sponsored health care. An estimated 3 million young adults had coverage between 2010 and 2016 because of the ACA’s dependent coverage requirement. This coverage policy was responsible for a rapid 14 percent reduction in the number of uninsured young adults immediately after the passage of the ACA. Uninsurance rates for young adults continued to decrease, by 8.7 percent, in the following years, except during the Trump administration. Research has overwhelmingly shown that young adults have had dramatically improved self-reported physical and mental health, increased early-stage cancer diagnosis, reduced poor birth outcomes, and are less likely to die of opioid overdose following the passage and expansions of the ACA. President Biden and Democrats in Congress are working to further lower costs so everyone can afford the health care they need. 

By The Numbers:

  • More than 28 million children and young adults with pre-existing conditions gained protection.
  • Uninsurance in young adults fell by about 14 percent in the years following the passage of the ACA thanks to Medicaid expansion and ACA provisions.
  • 710,000 children gained coverage through Medicaid expansion when their parents enrolled. 
  • In 2023, more than one in four, or 4.1 million of those enrolled in Marketplace coverage were between the ages of 18 and 34.

Thanks To The ACA

Expanded Medicaid. Uninsurance rates among young adults fell by nearly half as a result of the ACA’s Medicaid expansion, improving access to care. Research confirms expanding access to Medicaid for parents has had ripple effects on their children. In states that expanded Medicaid, more children gained health coverage and were more likely to have regular access to health care. Children in states that have not expanded Medicaid are almost twice as likely to be uninsured — and that gap is growing. 

Young Adults Can Stay On Their Parents’ Plan Until Age 26. People younger than 26 years old are eligible to be on their parents’ insurance even if they are married, a parent, don’t live with their parents, attend school, are not financially dependent on their parents, or are eligible to enroll in their employers’ plan. In 2023, more than one in four, or 4.1 million of those enrolled in Marketplace coverage were between the ages of 18 and 34.

More Than 28 Million Children & Young Adults With Pre-Existing Conditions Gained Protections. Thanks to the ACA, children with pre-existing conditions like asthma and diabetes cannot be charged more or denied coverage by their insurers. Nationwide, over 100 million Americans have a pre-existing condition, including more than 17 million people under the age of 18 and 11.3 million people aged 18 to 24.

Free Preventive Services And Annual Check-Ups. The ACA guarantees well-child visits with no cost-sharing for patients. These visits help prevent the development of chronic conditions and increase vaccinations among children. Plans sold on the ACA Marketplace must also cover preventive pediatric health benefits, including oral health and vision services. More than 36 million children with private insurance are also guaranteed free preventive care and are protected from lifetime and annual limits. However, these free preventive health services are now at risk of being overturned in the courts in the Braidwood Management v. Becerra case. 

Ended annual and lifetime limits. Because of the ACA, insurers can no longer put annual or lifetime limits on the care you receive, which is critical for children with complex medical needs. According to First Focus, without these protections, “children with cancer and other pediatric conditions, or babies that were born prematurely and spent the first weeks or months of their lives in the neonatal intensive care unit, could exhaust their annual and lifetime limits in a short time.” 

Improvements To CHIP & Medicaid Coverage. The ACA improved children’s coverage by increasing the federal matching rate for the Children’s Health Insurance Program (CHIP) and standardizing–and in many states, expanding–Medicaid eligibility for children. The ACA also ensures that states provide Medicaid coverage to children in foster care up to age 26. 

Contraception Use Covered Under The ACA Has Led To A Sharp Decrease In Unintended Pregnancies. Among young adults, the contraception mandate under the ACA has led to increased use of contraception, increased use of more effective contraceptives, and decreased risk of unintended pregnancy. The racial disparity between Black and white women using contraceptives has also reduced by an incredible 70.5 percent when analyzing contraceptive use pre- and post-passage of the ACA. 

Mental Health And Substance Abuse Treatment Are More Accessible Than Ever. Over 62 million Americans gained expanded benefits for mental health and substance use disorder because of the ACA. With over one-third of young Americans aged 18-25 living with mental illness, this coverage has been life-changing for many. Additionally, the ACA provided increased access to services for the 5.1 million young adults living with substance use disorder. Particularly, the ACA’s Medicaid expansion has played a direct role in reducing opioid-related mortality by 3.6 percent by expanding access to services for rural Americans, racial and ethnic minorities, and impoverished communities most affected by the opioid epidemic.

ashoup
In Fact Sheet, Research

FACT SHEET: The Affordable Care Act Has Improved Health Care for Seniors

Over the last 14 years, the ACA has helped tens of millions of Americans gain access to affordable health coverage. Thanks to President Biden’s efforts to lower the cost of health care, a record-breaking 21.3 million Americans signed up for coverage through the Marketplaces for 2024. President Biden built upon the ACA by further lowering premium and prescription drug costs through the Inflation Reduction Act. The new law has lowered annual premiums for people who buy their own coverage by an average of $2,400 per family and has saved the average 60-year-old couple with a household income of $75,000 approximately $1,900 in monthly premiums for Marketplace coverage. Building on the ACA’s closure of the prescription drug donut hole, President Biden’s Inflation Reduction Act reduces out-of-pocket drug costs for Medicare enrollees by capping monthly insulin costs at $35, providing recommended vaccines at no cost, introducing a new annual out-of-pocket spending cap, and negotiating lower drug prices. 

The ACA has survived countless repeal attempts and now it’s stronger than ever. Yet Republicans still want to destroy the ACA and all of its protections for over 100 million people with pre-existing conditions. Donald Trump has fully reignited his calls to repeal the ACA. As Trump is escalating his threat, Republicans in Congress and their allies are working overtime to dismantle reproductive care and access to vital preventive care, hike premiums, slash Medicare and Medicaid, reverse recent coverage gains, and raise prescription drug costs for the American people. 

This week, Protect Our Care is highlighting five key ways the ACA is working across the nation:

Monday, March 18: How the ACA helps women
Tuesday, March 19: How the ACA helps seniors & young people
Wednesday, March 20: How the ACA helps people with pre-existing conditions
Thursday, March 21: How the ACA helps people of color
Friday, March 22: How the ACA expanded affordable coverage to tens of millions of Americans

Background:

Among the many benefits of the ACA, the health care law ensures that the more than 50 million people enrolled in Part D coverage who may have otherwise fallen into a prescription drug coverage gap “donut hole” have their vital medications covered. The ACA guarantees no-cost coverage of preventive services, which has led to an increase in utilization among seniors and a decrease in catastrophic health costs. The ACA also laid a strong foundation for the Inflation Reduction Act’s measures to lower drug prices, including the new out-of-pocket cap on drug costs that went into effect in January 2024 and drops to $2,000 out-of-pocket cap in 2025, which will save nearly 19 million seniors about $400 per year. These benefits, along with the expansion of Medicaid, have improved the health of seniors across the country.

By the Numbers:

  • Over 50 million seniors are protected from the Medicare ‘donut hole’ coverage gap. 
  • Lifesaving free preventive care has led to an increase in utilization with one study showing that implementation of the ACA led to a 9 percent increase in colonoscopies among seniors.
  • The Balancing Incentives Program under the ACA has led to a 3.2 percent increase in daily home caregiving and better quality care for seniors.
  • Spillover effects from ACA coverage have resulted in a 17.4 percent increase in SNAP enrollment, leading to better health outcomes among low-income seniors.
  • The ACA’s 2014 Medicaid expansion led to seniors being 4 percent more likely to have dual Medicare and Medicaid coverage, allowing for more affordable health care and better health outcomes.
  • Through Medicaid expansion, 7.2 million Americans over 65 are enrolled in Medicaid and more than 8.5 million Americans ages 50 to 64 have health coverage.

People Over The Age Of 50 Save Thousands On Premiums. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, according to AARP. People who buy insurance on their own, especially early retirees, have been able to save thousands on health insurance thanks to the enhanced premium subsidies passed in the ARP and extended in the IRA.

Seniors Are Guaranteed Free Preventive Services And Annual Check-Ups. Around 61 million people with Medicare have access to free preventive services because of the Affordable Care Act. Additionally, Medicare beneficiaries likely see lower premiums thanks to the cost-saving measures implemented under the ACA.

Millions of Medicare Beneficiaries Are Benefiting From Higher Quality, More Coordinated Care. Provisions in the ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated high-quality care to the Medicare patients they serve, affecting nearly 9 million seniors.

32 Million Older Adults With Pre-Existing Conditions Gained Protections. Thanks to the ACA, people with pre-existing conditions like asthma and diabetes cannot be charged more or denied coverage by their insurers. Nationwide, half of all Americans have a pre-existing condition, including 32 million people aged 55-64. And now, millions of Americans who have contracted the coronavirus are also protected from discrimination by their insurance companies. 

A Closer Look At How The Affordable Care Act Is Working For Seniors Across The Country:

Seniors Saved Thousands On Prescription Drug Costs Thanks To The ACA. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 Centers on Medicare and Medicaid Services report.

The ACA’s Medicaid Expansion Saved The Lives Of At Least 19,200 Older Adults. According to the Center on Budget and Policy Priorities, Medicaid expansion saved the lives of 19,200 older adults aged 55 to 64 between 2014 and 2017. At the same time,15,600 older adults died prematurely as a result of their state’s decision not to expand the program.

ashoup
In Fact Sheet, Research

FACT SHEET: The Affordable Care Act Has Lowered Costs and Expanded Women’s Access to Care

Protect Our Care Is Marking the 14th Anniversary of the Affordable Care Act With 5 Days Celebrating the Growing Success of the Health Care Law Under President Biden

Over the last 14 years, the ACA has served as the backbone of the American health care system and has helped tens of millions of Americans gain access to affordable health coverage. Thanks to President Biden’s efforts to lower the cost of health care, a record-breaking 21.3 million Americans signed up for coverage through the Marketplaces for 2024. The Inflation Reduction Act lowered premiums for people who buy their own coverage by an average of $2,400 a year per family.

The ACA has survived countless repeal attempts and now it’s stronger than ever. Yet Republicans still want to destroy the ACA and all of its protections for over 100 million people with pre-existing conditions. Donald Trump has fully reignited his calls to repeal the ACA. As Trump is escalating his threat, Republicans in Congress and their allies are working overtime to dismantle reproductive care and access to vital preventive care, hike premiums, slash Medicare and Medicaid, reverse recent coverage gains, and raise prescription drug costs for the American people. Additionally, Republican allies in the courts are attacking the ACA’s requirement that insurers cover preventive services like birth control and breast cancer screenings for free, jeopardizing lifesaving care for millions. Read more about the case here. 

Over the next five days, Protect Our Care is highlighting five key ways the ACA is working across the nation: 

Monday, March 18: How the ACA helps women
Tuesday, March 19: How the ACA helps seniors & young people
Wednesday, March 20: How the ACA helps people with pre-existing conditions
Thursday, March 21: How the ACA helps people of color
Friday, March 22: How the ACA expanded affordable coverage to tens of millions of Americans

Background:

Among the many benefits of the ACA, the health care law ensures that women cannot be charged more than men for the same coverage. Additionally, 68 million women with pre-existing conditions like diabetes and asthma are protected from discrimination, and they are no longer subject to annual or lifetime limits. The ACA also guarantees free preventive care, such as mammograms, Pap smears, and other important screenings, in addition to providing birth control with no out-of-pocket fees. These benefits, along with the creation of the ACA Marketplace and expansion of Medicaid, have improved the health of women across the country. 

By the Numbers

  • 68 million women with pre-existing conditions cannot be charged more or denied coverage. 
  • 8.7 million women received affordable health care through the Marketplace thanks to the Affordable Care Act in 2023.
  • Nearly 2.2 million more women were able to access health care from the ACA Marketplace from 2021 to 2023 who may not have been able to afford health coverage before.
  • Marketplace users have saved over $800 annually thanks to the subsidy provisions in the IRA.
  • Over 53 percent of those enrolling for health coverage through the ACA Marketplace identify as a woman, representing around one in ten of all women between 19 and 64.
  • Between 66 percent and 75 percent of women are able to access IUDs and implants at no cost.
  • Women have been found to have improved birth outcomes thanks in part to the dependent coverage expansion, with one study showing women covered saw a 2.2 percent decrease in preterm births.
  • In states that have expanded Medicaid, there are around 7.0 fewer maternal deaths per 100,000 live births than in non-expansion states.

68 Million Women With Pre-Existing Conditions Cannot Be Charged More Or Denied Coverage. Prior to the ACA, conditions like asthma, diabetes, and even pregnancy were grounds for insurance companies to charge more or deny coverage altogether. Additionally, insurance companies could impose annual and lifetime limits on coverage, which further eroded access to care for the sickest patients. 

Women Cannot Be Charged More Than Men For The Same Coverage. Before the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than men for the same coverage, and 1 in 5 women reported postponing or going without preventive care due to cost. Thanks to the ACA, insurers cannot charge women more than men for the same coverage, and women gained access to important preventive care services with no out-of-pocket costs. 

Women Have Access To Affordable Health Coverage. The share of working-aged women making at or below 400 percent of the FPL who report difficulty accessing health coverage due to cost has fallen by over 25 percent since the ACA’s implementation. Low-income women in Medicaid expansion states aged 19 to 44 have seen a 3.8 percent reduction in unmet health care needs when compared to nonexpansion states.

Women Have Access To Free Preventive Care. All Marketplace plans must cover over 27 preventive services ranging from cancer screenings to pre- and post-natal care without any co-pay. Women are 5.1 percent more likely to access cholesterol screenings, 6.9 percent more likely to receive mammograms, 3.3 percent more likely to have blood pressure screenings, and 3.1 percent more likely to have talked to a doctor over the past twelve months.

Women Have Increased Access To Mental Health Treatment. Unmet mental health care needs for women have declined since the ACA’s implementation which has led to a decrease in emergency department visits for psychiatric diagnosis.

More Than 60 Million People Have Access To Birth Control With No Out-Of-Pocket Fees. The ACA guarantees that private health plans cover 18 methods of contraception and make them available to 62.4 million patients with no out-of-pocket costs. More than 99 percent of sexually active women have used contraceptives at some point in their lifetimes, and approximately 60 percent of women of reproductive age currently use at least one birth control method. In addition to increasing access to this essential treatment, this ACA provision has saved money for women and their families: women saved $1.4 billion on birth control pills alone in 2013. Between 66 percent and 75 percent of women are able to access IUDs and implants at no cost.

Women Can No Longer Face Discrimination In Health Care Settings. Section 1557 of the ACA prohibits discrimination on the basis of race, color, national origin, sex, age, or disability by any health program or activity receiving federal assistance. It also prohibits these types of discrimination in health programs and activities administered by HHS as well as the ACA marketplaces. 

Nursing Parents Gained Breastfeeding Support And Critical Workplace Protections. The Affordable Care Act requires insurance companies to cover breastfeeding support and counseling as well as breast pumps without cost-sharing for pregnant and nursing women. 

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In Fact Sheet, Research

FACT SHEET: 14 Years Later, The Affordable Care Act Is Woven Into the Fabric of America

Read the Full PDF Here

Next week marks the 14th anniversary of the passage of the Affordable Care Act (ACA). Since President Obama signed the ACA into law on March 23, 2010, it has become woven into the fabric of our nation. Thanks to President Biden’s efforts to lower the cost of health care, a record-breaking 21.3 million Americans signed up for coverage through the Marketplaces for 2024. The Inflation Reduction Act has built on the law’s strong foundation by lowering premiums for people who buy their own coverage by an average of $2,400 a year per family.

At the same time, about 24 million people have gained health care coverage through the ACA’s Medicaid expansion. Right now, one in four Americans is covered by Medicaid or the Children’s Health Insurance Program (CHIP). Medicaid expansion has decreased income inequality, increased access to preventative care, and saved lives. 

Millions of Americans depend on the ACA in order to stay healthy and financially secure. It’s not just about coverage. It includes a broad range of cost savings and protections that touch nearly every household in the country. For example, if the ACA is repealed, over 100 million Americans with pre-existing conditions could be denied coverage or charged more, 52 million seniors would have to pay more for prescription drugs, and insurance companies would not be required to cover preventative care, such as vaccinations, contraception, and cancer screening.

The ACA has survived countless repeal attempts, and now it’s stronger than ever. Yet Republicans still want to destroy the ACA and all of its protections for over 100 million people with pre-existing conditions. Donald Trump has reignited his calls to repeal the ACA. As Trump is escalating his threats to repeal the ACA, Republicans in Congress and their allies are working overtime to dismantle reproductive care, hike premiums, slash Medicare and Medicaid, reverse recent coverage gains, and raise prescription drug costs for the American people. 

14 years ago, not a single Republican voted for the ACA and since then, they have continuously called for repeal. In 2016, Republicans passed the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015, only to be vetoed by President Obama. 2017 brought numerous attempts at repeal all of which failed to pass and become law.

Yet the threats did not stop there. Several Republican candidates up for election in 2024 have campaigned on overturning the ACA. Donald Trump alone has promised to overturn the ACA at least seven times last year. 

President Biden has shown what it means to make health care better — he has lowered prescription drug and insurance costs, helped families connect to coverage, and taken on big drug companies and other corporate interests. The MAGA-Republican plan to gut health care will only take us backwards and throw the entire health care system into chaos.

A Closer Look at How the Affordable Care Act Is Lowering Health Care Costs Across the Country:

About 46 Million Americans Have Affordable Health Coverage. Because of the ACA, about 46 million Americans have health coverage through the Marketplace, Medicaid, or CHIP. 

More Than 21.3 Million People Signed Up For Coverage They Can Afford Through The Marketplace. In 2024, a record-breaking 21.3 million people who buy insurance on their own signed up for health coverage through the ACA Marketplace. This is the highest number of Americans to ever enroll during an Open Enrollment Period and it is thanks to policies that lowered premiums in President Biden’s American Rescue Plan and Inflation Reduction Act. Families are now saving an average of $2,400 a year on their health insurance premiums.

Americans Are Saving More Than Ever On Health Care Premiums. Most people receiving coverage through the Marketplace qualify for tax credits to help pay for their premiums, and the American Rescue Plan and Inflation Reduction Act made these savings more generous and available to more people. Four out of five people enrolling in a Marketplace plan have a plan for less than $10. The Inflation Reduction Act builds on the ACA by ensuring all enrollees never pay more than 8.5 percent of their household income on premiums. The Inflation Reduction Act expanded the eligibility for premium tax credits above 400 percent of the federal poverty level through 2025 — roughly $54,000 for a single person or $111,000 for a family of four. Previously, families earning more than 400 percent of the federal poverty level spent an average of 15 percent of their incomes on health insurance. Americans earning up to 150 percent of the federal poverty level (roughly $20,000 for a single person and $41,000 for a family of four) who buy their coverage on the Marketplace are able to enroll in a plan with $0 premiums.

Lower Health Costs Have Improved Access To Care And Financial Security. Between 2010 and 2018, the share of non-elderly adults with a problem paying a medical bill fell by 17 percent, the share who didn’t fill a prescription fell by 27 percent, the share who skipped a test or treatment fell by 24 percent, and the share who didn’t visit a provider when needing care fell by 19 percent.

Prescription Drugs Are Considered Essential. Thanks to the ACA, insurers have to cover what are known as “essential health benefits,” and that includes prescription drugs. This required all health insurance plans to cover at least one drug in every category and class of approved medicines.

More Than 60 Million Gained Access To Birth Control With No Out-Of-Pocket Costs. The ACA guarantees that private health plans cover all FDA-approved forms of contraception and make them available to 58 million patients with no out-of-pocket costs. More than 99 percent of sexually active women have used contraceptives at some point in their lifetimes, and approximately 60 percent of women of reproductive age currently use at least one birth control method. In addition to increasing access to this essential treatment, this ACA provision has saved money for women and their families: women saved $1.4 billion on birth control pills alone in 2013.

A Closer Look at How the Affordable Care Act Is Protecting Patients Across the Country:

Over 100 Million Americans With Pre-Existing Conditions Are Protected. Because of the ACA, insurers in the individual market can no longer drop or deny coverage, or charge more because of a pre-existing condition. Over 100 million Americans have a pre-existing health condition. Without the ACA, millions of Americans who have contracted COVID-19 would likely be deemed as having a pre-existing condition and be at the mercy of their insurance companies who could refuse to pay for needed care. 

The ACA Guarantees Comprehensive Coverage. Because of the ACA, insurers have to cover what are known as “essential health benefits,” such as maternity care, prescription drugs, and substance and mental health. Before the ACA, individual market plans often failed to cover these basic, and oftentimes preventive, health services. 

The ACA Ended Annual And Lifetime Limits, Including For People With Employer-Based Coverage. Thanks to the ACA, insurers can no longer put annual or lifetime limits on the care you receive. At the time the ACA was passed, 91 million Americans had health care through their employers that imposed lifetime limits. Many such plans capped benefits at $1 million, functionally locking people with complex medical needs out of coverage. 179 million Americans with employer coverage are protected from lifetime limits, in addition to the millions with ACA Marketplace coverage. 

Women Can No Longer Be Charged More Than Men. Because of the ACA, insurers can no longer charge women more than men for the same coverage, and insurers are now required to cover important health benefits like maternity care. Before the ACA, only 12 percent of individual market plans offered maternity care. The ACA established maternity coverage as one of the ten essential health benefits required on all new individual and small group policies. The American Rescue Plan created a pathway to coverage for pregnant Americans, allowing states to extend postpartum coverage under Medicaid from 60 days to 12 months following pregnancy. The United States has the highest rate of maternal mortality in the industrialized world, with 30 percent of maternal deaths occurring between six weeks and one year following delivery, after Medicaid coverage has ended.

LGBTQI+ Americans Are Protected From Discrimination By Health Insurance Companies. Republicans have worked to sabotage the Biden administration’s efforts to require health insurance plans offered through the ACA to include sexual orientation and gender identity as protected characteristics. LGBTQI+ Americans are more likely to be without health insurance than straight individuals. According to a Center for American Progress survey, in 2019, the LGBTQI+ uninsured rate was 20 percent in holdout states, compared to 8 percent in states that adopted Medicaid expansion. Access to affordable, quality health care plans under the ACA and its expansion under the American Rescue Plan and Inflation Reduction Act help combat the number of LGBTQI+ Americans who are uninsured. Premium subsidies made available by the ARP helped nearly 210,000 LGBTQI+ enrollees have access to zero-premium plans.

A Closer Look at How the Affordable Care Act Is Expanding Health Care Access Across the Country:

States Have The Option To Expand Medicaid. Because of the ACA, states can expand Medicaid to millions of adults who previously did not qualify for affordable health care. 24.3 million Americans were enrolled in Medicaid thanks to Medicaid expansion. Between 2013 and 2020, states that expanded their programs saw a 33.9 percent increase in Medicaid enrollment. 

Rural Hospitals Benefit From Medicaid Expansion And Lower Premiums. Through lower premiums and expanded Medicaid, the ACA has profoundly reduced uncompensated care costs, which are often the direct result of individuals who are uninsured or underinsured. Studies published in 2021 found that Medicaid expansion resulted in hospitals receiving higher reimbursements and decreased uncompensated care costs. In 2019, uncompensated care costs in expansion states were less than half of those in non-expansion states. Compared to 2013, hospitals’ uncompensated care costs decreased by more than $14 billion in 2017, or 26 percent. 

Medicaid Expansion Improved Health Outcomes And Saved Lives. A study published in the Journal of Health Economics found that Medicaid expansion reduced all-cause mortality in people aged 20 to 64 by 3.6 percent. According to the Center on Budget and Policy Priorities, Medicaid expansion saved the lives of 19,200 older adults aged 55 to 64 between 2014 and 2017. At the same time, 15,600 older adults died prematurely as a result of their state’s decision not to expand the program. 

Children Benefit From Medicaid Expansion. When parents have health insurance, their children are more likely to be insured. A study in Health Affairs found that 710,000 children gained public coverage as a result of their parents enrolling in Medicaid between 2013 and 2015. 

Medicaid Expansion Leads To Decrease In Income Inequality. A January 2021 study found the ACA helped reduce income inequality across the board, but far more dramatically in Medicaid expansion states. The bottom 10th percentile of earners In Medicaid expansion states saw a 22.4 percent boost in their income, compared to 11.4 percent in non-expansion states. A 2019 study found that Medicaid Expansion also caused a “significant” reduction in poverty. 

A Closer Look at How the Affordable Care Act Improves Access to Preventive Services and Reduces Racial Inequity:

ACA Requires Free Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes the 179 million Americans with employer coverage. Importantly, the ACA requires plans to cover all vaccinations recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP), including vaccines for COVID-19. Preventive care is essential to comprehensive coverage and because of the ACA, insurers have to cover what are known as “essential health benefits,” such as maternity care, prescription drugs, and substance and mental health. 

Medicaid Expansion Leads To Expansion In Available Preventive Care Services. Medicaid expansion has helped patients access preventive care, including colon cancer screenings. Expansion has also increased patient access to kidney transplants and made diabetes medication more affordable for low-income patients. The program was also tied to earlier diagnoses of colorectal cancer and reducing diabetes-related amputations.

Preventive Care Has Reduced Racial Disparities In Health Outcomes. Access to preventive care starts with access to affordable coverage. The ACA led to historic reductions in racial disparities in access to health care, but racial gaps in insurance coverage narrowed the most in states that adopted Medicaid expansion. The ACA significantly reduced racial disparities in the share of people who went without care because of cost. 

Medicaid Expansion Has Led To Improvements To Infant And Maternal Health. Whether coverage comes from Medicaid expansion or increased access to affordable coverage on the ACA Marketplace, coverage improves infant and maternal mortality outcomes. One study found that reductions in maternal mortality in expansion states were concentrated among Black mothers, “suggesting that expansion could be contributing to decreasing racial disparities in maternal mortality.” Expansion has also been tied to improving health outcomes for Black babies, significantly reducing racial disparities in low birth weight and premature birth. 

Preventive Care Leads To Improvements In Disease-Specific Diagnosis And Treatment. A 2017 study called preventive care “one of the most important health care strategies to facilitate early diagnosis and treatment, improve quality of life, and prevent premature death.” Access to preventive care through Medicaid expansion reduced racial disparities in cancer care and resulted in earlier diagnosis and treatment for Black patients. According to the Center for American Progress, Black women were more likely to receive care because of the ACA.

ashoup
In Fact Sheet, Research

NEW: State-By-State Fact Sheets Show How Republican Calls to Repeal the ACA Jeopardizes Health Care for Millions of People Across the Nation

Read the Fact Sheets Here. 

Washington, DC — Today, Protect Our Care is releasing 50 state-by-state fact sheets to underscore the threat of  Donald Trump’s promise to “terminate” the Affordable Care Act (ACA) and the MAGA Republican war on health care. The consequences of repealing the ACA would touch nearly every household in the country. In addition to 20 million losing coverage, over 135 million Americans with pre-existing conditions would lose critical protections, 49 million seniors would have to pay more for prescription drugs, insurance companies would not be required to cover preventative care, such as vaccinations, contraception, and cancer screenings, and could once again impose annual and lifetime limits on benefits and charge women more. Protect Our Care’s new fact sheets outline how repealing the ACA would have devastating ramifications across the nation. 

Protect Our Care Founder Leslie Dach issued the following statement: 

“After all the years, the Affordable Care Act is now woven into the fabric of the nation, and the data shows how the law lowers costs and improves care for Americans across the country. More people are relying on the ACA than ever before, and millions are finding health insurance for $10 or less a month thanks to President Biden and Democrats in Congress. However, Trump and MAGA Republicans will stop at nothing to repeal the ACA which would raise costs, rip away coverage, and eliminate critical protections including pre-existing conditions. Some things never change: Republicans are more concerned about siding with big drug and insurance companies than the health care and well-being of tens of millions of hardworking people across our country.”

The new reports come as new polling shows the favorability of the ACA is at an all-time high. Across the country, millions are ​​counting on it to protect their coverage and lower their costs. Thanks to President Biden and Democrats in Congress, 80% of people can now get coverage through the ACA for under $10. In the first week of the 2024 open enrollment period, a record 1.6 million people signed up for health care coverage on the Affordable Care Act (ACA) Marketplace. The ACA is extremely popular and provides coverage to more than ever before.

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In Fact Sheet, Research

FACT SHEET: If Republicans Get Their Way, 65 Million Seniors Will Pay More For Health Care

The Inflation Reduction Act reduces the cost of prescription drugs and slashes costs for millions of seniors. Every House and Senate Republican in 2021 voted against the provisions in the Inflation Reduction Act giving Medicare the power to negotiate prices on select drugs, lowering drug prices, reducing health care premiums, capping insulin costs, and improving care for seniors and people with disabilities. 

Currently, price negotiations are underway for ten drugs which make up around 20 percent of all Medicare Part D spending and are taken by nearly 9 million people. Americans currently pay two to four times more for prescriptions than people in other countries and if Republicans have their way that will only increase. The repeal of the Inflation Reduction Act is at the very top of the Republican legislative agenda and they are just getting started. If the history of efforts to repeal the Affordable Care Act is any indication, the Republican party will continue to attempt to block life-saving programs, preventing Americans from getting quality and affordable health care.

If the Inflation Reduction Act is repealed: 

  • GONE: Medicare’s power to negotiate lower prices for the most popular and expensive prescription drugs, leading to higher out-of-pocket costs for more seniors.
  • GONE: Medicare beneficiaries’ prescription drug savings, including a $2,000 annual out-of-pocket cap and protections from Big Pharma’s price gouges. 
  • GONE: Free vaccines for seniors, including for shingles and pneumonia. 
  • GONE: $35 monthly insulin caps for Medicare beneficiaries.
  • GONE: Improving racial and ethnic health disparities will regress as insurance becomes less affordable.
  • GONE: Expanded eligibility for the Extra Help program, putting affordable prescription drug coverage further out of reach for millions of seniors.

Republicans have partnered with drug companies to roll back Medicare’s price negotiation power. Negotiating lower prices remains overwhelmingly popular among voters of all parties across the country. Unfortunately, Republicans are attempting to repeal the Inflation Reduction Act in its entirety, placing these equity-advancing improvements at risk while drug companies simultaneously, in order to hoard their record profits, try to strip away Medicare’s price negotiating power, which will save taxpayers tens of billions of dollars, through junk lawsuits. If these efforts succeed, companies like Merck and Bristol Myers Squibb, who already spent over $100 million to lobby against the initial passage of the Inflation Reduction Act, will continue raking in billions annually on drugs with no generic alternative while charging Americans four times more than other high-income countries. While 64 Democrats have co-sponsored legislation to expand Medicare’s price negotiation power for private insurance, Republicans continue to give into lobbying campaigns by the pharmaceutical industry, turning their backs on the American people by standing in opposition to any legislation reducing drug prices. 

Repealing the Inflation Reduction Act remains a top priority for Republicans in Congress. As recently as June of 2023, the Republican Study Committee (RSC), a panel that represents 175 House Republicans, introduced a budget proposal for fiscal year 2024 that would privatize Medicare and fundamentally destroy Social Security. Within the proposal’s over $16 trillion in cuts to programs like Medicare, Medicaid, and Social Security, the RSC’s plan would repeal vital aspects of the Inflation Reduction Act like Medicare price negotiation power. The Republican party will continue to attempt to block life-saving programs, preventing Americans from getting quality and affordable health care.

Despite what they say publicly, slashing Medicare is a primary goal for elected Republicans. In 2023, Republicans came out in droves supporting cuts to Medicare. From the Republican House Ways and Means Committee Chairman Jason Smith floating potential Medicare cuts to Rep. Bruce Westerman supporting caps in Medicare spending, it is clear Republican leadership, despite what they may say publicly, are itching to cut spending to Medicare. Throughout recent negotiations to fund the government at the end of fiscal year 2023, Former Speaker McCarthy and Republicans advocated for a 2024 budget that would include over $58 billion more cuts to Medicare and Medicaid not agreed to during the equally fraught debt limit negotiations.

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In Fact Sheet, Research

FACT SHEET: 49 Million Seniors Will Save On Out-Of-Pocket Spending On Prescription Drugs

Seniors and hardworking families are paying too much for prescription drugs – more than any other country in the world – and it’s forcing them to choose between their medication and food for their families. But, that’s changing. 

Medicare plans for 2024 will include new benefits and lower costs for seniors because of President Biden’s Inflation Reduction Act, including free vaccinations for illnesses like shingles and the flu, a $35 monthly cap on insulin costs, protections from outrageous price hikes, and a new annual cap of approximately $3,300 on out-of-pocket expenses for drugs.

Starting in 2025, Medicare beneficiaries will also see lower drug costs across the board thanks to the Inflation Reduction Act’s new $2,000 annual out-of-pocket cap on drug costs. Soon, seniors will save even more thanks to Medicare negotiation.  

FAST FACTS:

  • 49 million Medicare Part D beneficiaries will have out-of-pocket costs for prescription drugs capped at approximately $3,300 per year in 2024 and $2,000 per year beginning in 2025. More than 1.4 million Medicare enrollees paid more than $2,000 in out-of-pocket costs in 2020.
  • 3.5 million seniors struggle to afford their medication, forcing them to skip or ration doses.
  • In 2024, 400,000 low-income seniors will receive more help affording prescription drugs through the Medicare Part D Low-Income Subsidy Program.
  • In 2025, nearly 19 million Medicare enrollees will save an average of about $400 per year on out-of-pocket prescription drug costs. Enrollees with the highest drug costs will save an average of $2,500 per year. 

Capping Out-Of-Pocket Spending For Seniors. Seniors with serious conditions like cancer, multiple sclerosis, and rheumatoid arthritis will save thousands of dollars on prescriptions under the Inflation Reduction Act. More than 1.4 million Medicare enrollees paid more than $2,000 in out-of-pocket costs in 2020. The Inflation Reduction Act also allows out-of-pocket spending to be smoothed over the course of the year beginning in 2025, so patients are not forced to pay the entirety of their out-of-pocket cost all at one time.

Helping Millions Of Seniors Who Can’t Afford Their Prescriptions. The Inflation Reduction Act will help 3.5 million older Americans who have trouble affording their medication. Over the decade from 2009 to 2019, out-of-pocket spending for older Amerians rose by 41 percent. Seniors often have to sacrifice basic needs such as food or clothing to be able to afford their prescriptions due to rising costs. 

Republicans Voted Against Lower Drug Prices For Millions of Americans. Every Republican in Congress voted against the Inflation Reduction Act effectively taking money out of the pockets of seniors and putting it in Big Pharma’s. Since its passage, Republicans in Congress have repeatedly introduced legislation to repeal the Inflation Reduction Act’s health care provisions, which would increase health care costs for millions. If the history of efforts to repeal the Affordable Care Act is any indication, the Republican party will continue to attempt to block life-saving programs, preventing Americans from getting quality and affordable health care. 

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