Affordable Care Act

In 2007-2010, HCANEF led the fight to pass, defend and implement the landmark Affordable Care Act (ACA) which now provides coverage to over 40 million people through private plans and Medicaid. Over the last decade, the ACA has reduced the number of uninsured people in the United States to historically low rates (8% in 2022), stopped insurance companies from discriminating against over 150 million people with pre-existing conditions and created new rules that standardized coverage for essential health benefits. 

Thanks to the ACA, insurance companies can no longer charge women more for insurance than men, deny people coverage for basic services like mental health, addiction, or pediatric care or place arbitrary caps on care or coverage. The ACA reduced health disparities for Black and Brown Americans by ensuring millions more people of color could access affordable coverage through private insurance and Medicaid for the first time.

• • Download our ACA Anniversary (March 23rd) Toolkit here

Medicaid

Medicaid is a family health insurance program for people of all ages. It is a leading source of health coverage for low-wage workers, for pregnant women, for children (also through CHIP), for people with disabilities, and for seniors who need long-term care services. Medicaid is paid for by both states and the federal government and provides health coverage and services with very low administrative costs and generates significant economic benefit to local communities, often as the lead revenue source for rural and urban hospitals and clinics. 

Medicaid is an accordion program that can expand, or contract based on needs. It is often a key part of disaster relief, public health emergency, and national security response efforts like those we saw during Hurricane Katrina, the 9/11 terrorist attacks and, most recently, the COVID 19 pandemic. Currently, over 70 million Americans of all ages are enrolled in Medicaid. The growth in the program is largely due to the aging of the population and growing number of people with disabilities, the passage of the Affordable Care Act which expanded Medicaid in all by 10 states to provide coverage to those who previously were not eligible and the even more recent expansion of Medicaid under the American Rescue Plan through streamlined enrollment and easier eligibility.

Medicare

Medicare is the nation’s health program for people with disabilities and people 65 and over. It was signed into law along with Medicaid by President Lyndon B. Johnson. Since then, Medicaid and Medicare have been protecting the health and well-being of millions of American families, saving lives, and improving the economic security of our nation. Medicare has four parts: 

• • Medicare Part A provides coverage for inpatient and hospital treatment.
  • Medicare Part B provides coverage for outpatient care like doctors’ visits, medical supplies, and preventive services.
  • Medicare Part C provides privatized Medicare Advantage insurance plans as an alternative to traditional Medicare. Medicare Advantage plans now make up nearly half of all coverage in Medicare. 
  • Medicare Part D provides prescription drug coverage. Medicare is the largest purchaser of prescriptions in the nation. Over 51 million people are enrolled in Part D plans.

Over 65 million people are enrolled in Medicare. It’s one of the most loved and best supported government programs in history. As the population ages, increased strain on the program will require government action to keep the Trust Fund solvent and ensure that Medicare not only can maintain current benefits but can also expand benefits to fill gaps like dental, vision and hearing coverage that currently exist in the program. 

In 2010, the ACA made critical improvements to Medicare that provided for the first time free preventive care for enrollees, lower prescription drug costs by closing the Part D “donut hole” and rebates to enrollees. Then, again in 2022, President Biden and Democrats in Congress made more historic changes to lower costs in the program by finally lifting the ban on drug price negotiations, creating a first-ever out of pocket cap on insulin and other prescriptions, making all vaccines free, and penalizing drug corporations that raise their prices faster than inflation. Learn more at LowerDrugPricesNow.org

There’s much more left to do to lower drug prices and cut waste and corporate price gouging in Medicare. 

Corporate Accountability

Making health care truly affordable, accessible and reliable in the United States depends on improving quality, expanding coverage, addressing inequities and reining in corporate greed, monopolization and price-gouging.

The United States spends twice as much on health care as comparable nations even though our health outcomes are not as good as peer nations that spend less. There are a wide variety of reasons for this that are not about coverage, but there are also many reasons endemic to a for-profit health system that is rife with perverse incentives to spend more without considering value. Administrative costs, labor costs, prescription drug costs, are all high in the United States. CEO pay, high concentration and lack of competition in the healthcare sector and surprise medical bills are all associated with high costs and all require regulatory action to make health a priority over profit.