Review of the ACA

The Affordable Care Act (ACA) was a landmark statute that had three main goals.

 David Dillon, Michael Lin and Matthew Damiani

The Affordable Care Act (ACA) was a landmark statute with three main goals in mind:

  1. Make health care more affordable and available.
  2. Expand the Medicaid program to cover more people.
  3. Support innovative health care models to lower costs.1

To meet the ACA’s goals, the designers of the legislation aimed to improve affordability, accessibility and quality by:

  • Removing preexisting condition clauses to guarantee issue.
  • Creating subsidies to subsidize premiums and cost sharing.
  • Adding an individual mandate.

The ACA provided an option for Americans who were unable to obtain health insurance coverage due to preexisting medical conditions (denied coverage), unemployment (no group coverage), income levels (qualifying for Medicaid) and age (qualifying for Medicare). It is clear the ACA has been successful in insuring more Americans, as the uninsured rate has dropped from 16 percent to 9 percent over the last 10 years, as shown in Figure A.2

Figure A: U.S. Health Insurance Coverage by Type

Hover Over Image for Specific Data

Source: Kaiser Family Foundation. Health Insurance Coverage of the Total Population. Kaiser Family Foundation (accessed December 15, 2019).
Note the 2018 numbers do not sum to 100% due to rounding.

David Dillon, FSA, MAAA, is senior vice president & principal at Lewis & Ellis.
Michael Lin, FSA, MAAA, is a consulting actuary at Lewis & Ellis.
Matthew Damiani is an actuarial associate at Lewis & Ellis.

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