376:
attempts to eliminate the mandate, and has created significant uncertainty about the future of the ACA. Enrollments had been running ahead of 2016 prior to
President Obama leaving office, with 9.8 million expected to sign-up, so President Trump's actions potentially cost about 600,000 national enrollments (i.e., 9.8 million expected − 9.2 million actual = 0.6 million impact). Of the 9.2 million, 3.0 million were new customers and 6.2 million were returning. The 9.2 million excludes the 11 states that run their own exchanges, which have signed up around 3 million additional people. These figures also exclude the additional coverage due to the Medicaid expansion, which covers another approximately 10 million persons, as described in the impact section above.
368:
402:, a major Medicaid provider, said that it was considering exiting some markets in 2018, citing "too many unknowns with the marketplace program." Molina lost $ 110 million in 2016 due to having to contribute $ 325 million more than expected to the ACA "risk transfer" fund that compensated insurers with unprofitable risk pools. These pools were established to help prevent insurers from artificially selecting lower-risk pools.
333:
example, a study published in 2016 found that the average requested 2017 premium increase among 40-year-old non-smokers was about 9 percent, according to an analysis of 17 cities, although Blue Cross Blue Shield proposed increases of 40 percent in
Alabama and 60 percent in Texas. However, some or all of these costs are offset by subsidies, paid as tax credits. For example, the
389:
Western
Missouri without a coverage option. Anthem announced plans to withdraw from Ohio and later Wisconsin and Indiana, describing the market as "volatile" and referring to the difficulty in pricing its plans "due to the shrinking individual market as well as continual changes in federal operations, rules and guidance."
255:
Bronze plans were the second most popular in 2015, making up 22% of marketplace plan selections. Silver plans were the most popular, accounting for 67% of marketplace selections. Gold plans were 7%. Platinum plans accounted for 3%. On average across the four metal tiers, premiums were up 20% for HMOs
79:
In June small business tax credits took effect. For certain small businesses, the credits reached up to 35% of premiums. At the same time, uninsured people with pre-existing conditions could access the federal high-risk pool. Also, participating employment-based plans could obtain reimbursement for a
379:
In
February, Humana announced that it would withdraw from the individual insurance market in 2018, citing "further signs of an unbalanced risk pool." That month the IRS announced that it would not require that tax returns indicate that a person has health insurance, reducing the effectiveness of the
337:
reported that for the second-lowest cost "Silver plan" (a plan often selected and used as the benchmark for determining financial assistance), a 40-year-old non-smoker making $ 30,000 per year would pay effectively the same amount in 2017 as they did in 2016 (about $ 208/month) after the subsidy/tax
228:
A study found that average premiums for the second-cheapest ( silver) plan were 10–21% less than average individual market premiums in 2013, while covering many more conditions. Credit for the reduced premiums was attributed to increased competition stimulated by the larger market, greater authority
135:
ruled that the cost of covering only the individual employee would be considered in determining whether the cost of coverage exceeded 9.5% of income. Family plans would not be considered even if the cost was above the 9.5% income threshold. This was estimated to leave 2–4 million
Americans unable to
383:
Aetna CEO Mark
Bertolini stated that ACA was in a "death spiral" of escalating premiums and shrinking, skewed enrollment. However, a U.S. judge found that the Aetna CEO misrepresented why his company was leaving the exchanges; an important part of the reason was the Justice Department's opposition
346:
The number of ACA nonprofit insurance cooperatives for 2017 fell from 23 originally to 7 for 2017. The remaining 7 posted annual losses in 2015. A General
Accountability Report found that co-ops’ 2015 premiums were generally below average. At the end of 2014, money co-ops and other ACA insurers had
180:
CMS reported in 2013 that, while costs per capita continued to rise, the rate of increase in annual healthcare costs had fallen since 2002. Per capita cost increases averaged 5.4% annually between 2000 and 2013. Costs relative to GDP, which had been rising, had stagnated since 2009. Several studies
66:
Obama's previous unambiguous assurance that consumers' could keep their own plans became a focal point for critics, who challenged his truthfulness. On
November 7, 2013, President Obama stated: "I am sorry that are finding themselves in this situation based on assurances they got from me." Various
388:
withdrew from Iowa in April. As of May, no insurer had indicated its intention to offer ACA insurance in
Nebraska. Also in May Blue Cross and Blue Shield of Kansas City announced it would withdraw from Missouri and Kansas's individual markets in 2018, potentially leaving nearly 19,000 residents in
300:
The five major national insurers expected to lose money on ACA policies in 2016. UnitedHealth withdrew from the
Georgia and Arkansas exchanges for 2017, citing heavy losses. Humana exited other markets, leaving it operating in 156 counties in 11 states for 2017. 225 counties across the country had
292:
cost-sharing (for higher employee contributions, deductibles and co-payments). 60% planned to further increase cost-sharing. Coverage and benefits were not expected to change. Approximately one fifth said ACA had pushed them to reduce their workforce. A larger number said they were raising prices.
83:
In July the Pre-Existing Condition Insurance Plan (PCIP) took effect to offer insurance to those who had been denied coverage by private insurance companies because of a pre-existing conditions. Despite estimates of up to 700,000 enrollees, at a cost of approximately $ 13,000/enrollee, only 56,257
291:
A survey of New York businesses found an increase of 8.5 percent in health care costs, less than the prior year's survey had expected. A 10 percent increase was expected for 2017. Factors included increased premiums, higher drug costs, ACA and aging workers. Some firms lowered costs by increasing
70:
In late 2013, the Obama Administration announced a transitional relief program that would let states and carriers allow non-compliant individual and small group policies to renew at the end of 2013. In March 2014, HHS allowed renewals as late as October 1, 2016. In February 2016, these plans were
282:
As of March 2016 11.1 million people had purchased exchange plans, while an estimated 9 million to 10 million people had gained Medicaid coverage, mostly low-income adults. 11.1 million were still covered, a decline of nearly 13 percent. 6.1 million uninsured 19- to 25-year-olds gained coverage.
263:
Some 47% of the 2015 ACA plans sold on the Healthcare.gov exchange lacked standard out-of-network coverage. Enrollees in such plans typically received no coverage for out-of-network costs (except for emergencies or with prior authorization). A 2016 study on Healthcare.gov health plans found a 24
62:
At various times during and after the ACA debate, Obama stated that "if you like your health care plan, you'll be able to keep your health care plan". However, in the fall 2013 millions of Americans with individual policies received notices that their insurance plans were terminated, and several
319:
One of the causes of insurer losses is the lower income, older and sicker enrollee population. One 2016 analysis reported that while 81% of the population with incomes from 100 to 150% of the federal poverty level signed up, only 45% of those from 150 to 200% did so. The percentage continued to
304:
Aetna cancelled planned expansion of its offerings and following an expected $ 300 million loss in 2016 and then withdrew from 11 of its 15 states. In August 2016 Anthem said that its offerings were losing money, but also that it would expand its participation if a pending merger with Cigna was
332:
in the form of tax credits to the individuals or families purchasing the insurance, based on income levels. Higher income consumers receive lower subsidies. While pre-subsidy prices rose considerably from 2016 to 2017, so did the subsidies, to reduce the after-subsidy cost to the consumer. For
454:
estimated his action would cost $ 200 billion, cause insurance sold on the exchange to cost 20% more and cause one million people to lose insurance. The proposed legislation will also provide more flexibility for state waivers, allow a new "Copper Plan" or catastrophic coverage for all, allow
375:
More than 9.2 million people signed up for care on the national exchange (healthcare.gov) for 2017, down some 400,000 from 2016. This decline was due primarily to the election of President Trump, who pulled advertising encouraging people to sign up for coverage, issued an executive order that
259:
A 2015 study found 14% of privately insured consumers received a medical bill in the past two years from an out-of-network provider in the context of an overall in-network treatment event. Such out-of-network care is not subject to the lower negotiated rates of in-network care, increasing
311:
Another analysis found that 17 percent of eligibles may have a single insurer option in 2017. North Carolina, Oklahoma, Alaska, Alabama, South Carolina and Wyoming were expected to have a single insurer, while only 2 percent of 2016 eligibles had only one choice.
99:
The average beneficiary in the prior coverage gap would have spent $ 1,504 in 2011 on prescriptions. Such recipients saved an average $ 603. The 50 percent discount on brand name drugs provided $ 581 and the increased Medicare share of
2774:
1896:
177:, the website that offers insurance through the exchanges operated by the federal government, crashed on opening and suffered endless problems. Operations stabilized in 2014, although not all planned features were complete.
260:
out-of-pocket costs. Another 2015 study found that the average out-of-network charges for the majority of 97 medical procedures examined "were 300% or higher compared to the corresponding Medicare fees" for those services.
118:
decided on June 28, 2012, the Supreme Court ruled that the individual mandate was constitutional when the associated penalties were construed as a tax. The decision allowed states to opt out of the Medicaid expansion.
192:
Out-of-pocket costs rose, reducing demand for healthcare services. The proportion of workers with employer-sponsored health insurance requiring a deductible climbed to about three-quarters in 2012 from about half in
196:
ACA changes that aim to shift the healthcare system from paying-for-quantity to paying-for-quality. Some changes occurred due to healthcare providers acting in anticipation of future implementation of reforms.
315:
Aetna, Humana, UnitedHealth Group also exited various individual markets. Many local Blue Cross plans sharply narrowed their networks. In 2016 two thirds of individual plans were narrow-network HMO plans.
251:
By the beginning of the year, 11.7 million had signed up (ex-Medicaid). On December 31, 2015, about 8.8 million consumers had stayed in the program. Some 84 percent, or about 7.4 million, were subsidized.
384:
to the intended merger between Aetna and Humana. Aetna announced that it would exit the exchange market in all remaining states. It stated that its losses had grown from $ 100M in 2014 to $ 450M in 2016.
143:
provision had saved individual insurance consumers $ 1.2 billion in 2011 and $ 2.1 billion in 2012, reducing their 2012 costs by 7.5%. The bulk of the savings were in reduced premiums, but some came from
338:
credit, despite large increases in the pre-subsidy price. This was consistent nationally. In other words, the subsidies increased along with the pre-subsidy price, fully offsetting the price increases.
2176:
3044:
2708:
156:
3141:
2754:
935:
437:
51:
in 1965. Once the law was signed, provisions began taking effect, in a process that continued for years. Some provisions never took effect, while others were deferred for various periods.
3131:
2802:
1295:
114:
2011:
163:
2702:
36:
1770:
96:", requiring insurers to issue policies to such children. By 2011, insurers had stopped marketing child-only policies in 17 states, as they sought to escape this requirement.
1641:
308:
Blue Cross/Blue Shield Minnesota announced that it would exit individual and family markets in Minnesota in 2017, due to financial losses of $ 500 million over three years.
1847:
3059:
3171:
3161:
2219:
59:
Plans purchased after the date of enactment, March 23, 2010, or old plans that changed in specified ways would eventually have to be replaced by ACA-compliant plans.
1161:
1051:
661:
450:
reached a compromise to amend the Affordable Care Act to fund cost cost-sharing reductions. President Trump had stopped paying the cost sharing subsidies and the
347:
counted on risk corridor payments that didn't materialize. Maryland's Evergreen Health claims that ACA's risk-adjustment system does not adequately measure risk.
225:
the Court issued an injunction allowing the evangelical college and other religiously affiliated nonprofit groups to completely ignore the contraceptive mandate.
2480:
912:
209:
released a non-partisan study that concluded that the administration did not provide "effective planning or oversight practices" in developing the ACA website.
2037:
3105:
2764:
820:
770:
1870:
1452:
988:
359:
issued an executive order to accept the expansion, becoming the 32nd state to do so. The program was expected to enroll an additional 300,000 Louisianans.
92:
As of September 23, 2010, pre-existing conditions could no longer be denied coverage for children's policies. HHS interpreted this rule as a mandate for "
2628:
1922:
1273:
17:
965:
170:
option for employees. In October 2011 the administration announced it was unworkable and would be dropped. The CLASS Act was repealed January 1, 2013.
1481:
943:
2371:
2307:
3090:
1552:
1096:
1821:
2404:
1793:
1197:
3054:
406:
2454:
2759:
2718:
2258:
2353:
2961:
1666:
392:
The CBO reported in March 2017 that the healthcare exchanges were expected to be stable; i.e., they were not in a "death spiral." In June,
186:
883:
2329:
1618:
792:
3156:
2516:
2100:
1577:
2125:
868:
2549:
1340:
428:
By 2019, 35 states and the District of Columbia had either expanded coverage via traditional Medicare or via an alternative program.
3151:
2901:
1077:
589:
1667:"Supplemental Survey Report: Empire State Manufacturing Survey/Business Leaders Survey Firms Assess Effects of Affordable Care Act"
2607:
by selecting, in the Year menu, the most recent year that lists Title 42. In Title 42, seek section 18001 and subsequent sections.
2286:
2149:
2931:
1990:
410:
206:
40:
1518:
3064:
2749:
2671:
2644:
385:
2081:
3146:
2201:
744:
628:
29:
1318:
1224:
1013:
417:
2233:
1684:
301:
access to only a single ACA insurer. A study released in May estimated that 664 counties would have one insurer in 2017.
3166:
3126:
2813:
2713:
1387:
396:
announced that it intended to initiate coverage in Nevada, Kansas and Missouri and expand coverage in Ohio and Florida.
25:
2567:
2066:
3021:
2851:
1956:
451:
2045:
1162:
So, yeah, the health-care bill was really an awful piece of legislation that sent the revolving door spinning faster
2921:
730:
220:
152:
1596:
843:
2831:
2739:
1368:
1642:"20 million people have gained health insurance coverage because of the Affordable Care Act, new estimates show"
610:
218:
the Supreme Court exempted closely held corporations with religious convictions from the contraception rule. In
3100:
1406:
1055:
167:
132:
44:
662:"Barack Obama says that what he'd said was you could keep your plan 'if it hasn't changed since the law passed
2202:"Aetna will exit Obamacare markets in Virginia in 2018, citing expected losses on individual plans this year"
1032:
2881:
2507:"The Senate's Tax Bill Eliminates the Individual Mandate for Health Insurance. Here's What You Need to Know"
2291:
256:
and 18% for EPOs. Premiums for POS plans were up 15% from 2015 to 2016, while PPO premiums were up just 8%.
243:
A 2016 analysis found that health care spending by the middle class was 8.9% of household spending in 2014.
2012:"2017 Premium Changes and Insurer Participation in the Affordable Care Act's Health Insurance Marketplaces"
1118:
Madara, Matthew R. (February 11, 2014). "ACA Employer Shared Responsibility Delay Included in Final Regs".
305:
approved. Aetna and Humana's exit for 2017 left 8 rural Arizona counties with only Blue Cross/Blue Shield.
173:
The launch for both the state and federal exchanges was troubled due to management and technical failings.
3011:
2783:
2636:
1432:
420:. The CBO estimated that the repeal would cause 13 million people to lose their health insurance by 2027.
214:
2481:"Sen. Orrin Hatch: Repealing the individual mandate tax is the beginning of the end of the ObamaCare era"
3069:
2723:
2530:
2428:
1743:
1250:
71:
allowed to renew up until October 1, 2017, but with a termination date no later than December 31, 2017.
1718:
3074:
2640:
2616:
1201:
2620:
2698:
2694:
2680:
2664:
1166:
166:(or CLASS Act) was enacted as Title VIII of the ACA. It would have created a voluntary and public
3017:
2971:
2951:
2841:
2744:
1345:
1139:
709:
687:
560:
1453:"Supreme Court grants Wheaton College an injunction against contraception mandate accommodation"
2891:
2379:
2213:
1964:
1930:
1692:
1526:
1489:
1438:
1179:
585:
552:
544:
503:
495:
399:
334:
264:
percent increase in the percentage of ACA plans that lacked standard out-of-network coverage.
20:, often shortened to the Affordable Care Act (ACA) or nicknamed Obamacare, is a United States
3136:
2967:
2867:
2861:
2511:
2506:
1052:"Beyond Rebates: How Much Are Consumers Saving from the ACA's Medical Loss Ratio Provision?"
534:
485:
367:
356:
93:
21:
3001:
2795:
2610:
1771:"Following Some Withdrawals, More Counties Could Have One ACA Marketplace Insurer in 2017"
443:
2101:"Humana to quit Obamacare exchanges in 2018, providing fuel for Trump's 'repeal' efforts"
581:
Medicare and Medicaid at 50: America's Entitlement Programs in the Age of Affordable Care
1134:
3036:
2871:
2821:
2657:
633:
174:
43:'s most significant regulatory overhaul and expansion of coverage since the passage of
3120:
2927:
2568:"CBO says Trump's Obamacare sabotage would cost $ 194 billion, drive up premiums 20%"
797:
606:
578:
Cohen, Alan B.; Colby, David C.; Wailoo, Keith A.; Zelizer, Julian E. (1 June 2015).
234:
564:
2997:
2987:
2981:
447:
416:
On December 20, 2017, the individual mandate was repealed starting in 2019 via the
380:
individual mandate, in response to an executive order from President Donald Trump.
268:
101:
32:
2624:
2259:"Nearly 19,000 in Missouri could be stranded after insurer pulls out of Obamacare"
1897:"In North Carolina, ACA insurer defections leave little choice for many consumers"
455:
interstate insurance compacts, and redirect consumer fees to states for outreach.
136:
afford family coverage under their employers’ plans and ineligible for subsidies.
2604:
579:
2857:
274:
The average price of non-generic drugs rose 16.2% in 2015 and 98.2% since 2011.
2957:
2837:
2234:"Obamacare just suffered 2 big blows from insurance companies as repeal looms"
490:
473:
230:
145:
140:
2383:
1968:
1934:
1696:
1530:
1493:
548:
499:
240:
Many of the initial plans featured narrow networks of doctors and hospitals.
2937:
771:"The White House's Website Still Says If You Like Your Plan You Can Keep It"
1923:"Obamacare Options? In Many Parts of Country, Only One Insurer Will Remain"
556:
539:
522:
507:
1794:"ObamaCare problems deepen as insurers scramble to stem losses | Fox News"
936:"Supreme Court justices face important rulings in upcoming term September"
884:"Health Care Reforrm Law's Impact on Child-Only Health Insurance Policies"
3095:
2917:
2907:
2897:
2847:
2827:
2484:
1798:
1748:
48:
3007:
1482:"Think Your Obamacare Plan Will Be Like Employer Coverage? Think Again"
1410:
393:
329:
67:
bills were introduced in Congress to allow people to keep their plans.
2649:
2991:
2977:
2947:
2941:
2911:
2877:
2631:
2372:"Trump Says Market Is Failing, but One Insurer Bets Big on Obamacare"
2330:"Two of four insurers will no longer sell Obamacare plans in Indiana"
1848:"Obamacare insurers dwindle as Humana, UnitedHealthcare exit Arizona"
80:
portion of the cost of providing health insurance to early retirees.
2082:"Affordable Care Act signups dip amid uncertainty and Trump attacks"
745:"Health insurers say they're canceling plans because of federal law"
2287:"Anthem's Exit From Ohio Exchange Ups Ante for GOP Health Overhaul"
1619:"About 1.6M drop-outs from ObamaCare coverage this year | Fox News"
2887:
2455:"Analyst Sees Danger for House Republicans After Health Bill Vote"
521:
Blumenthal, David; Abrams, Melinda; Nuzum, Rachel (18 June 2015).
366:
2126:"IRS weakens enforcement of Obamacare individual mandate: Report"
1097:"Continuing to Implement the ACA in a Careful, Thoughtful Manner"
2405:"One Insurer Says Obamacare in 'Death Spiral,' Another May Quit"
2308:"Anthem to withdraw from Wisconsin health insurance marketplace"
1640:(ASPA), Assistant Secretary for Public Affairs (March 3, 2016).
966:"Status of State Action on the Medicaid Expansion Decision"
646:
189:, which limited the ability of consumers to purchase healthcare;
2653:
2550:"2 Senators Strike Deal on Health Subsidies That Trump Cut Off"
1871:"Minnesota's Largest Health Insurer Will Drop Individual Plans"
1274:"Senate Democrats frustrated with botched rollout of Obamacare"
710:"Obama apologizes for insurance cancellations due to Obamacare"
371:
Tax Cuts and Jobs Act - Number of additional persons uninsured.
2038:"Louisiana to Expand Medicaid: Outlook for the States in 2016"
1822:"Aetna's Obamacare Reversal Is Latest Blow to U.S. Health Law"
1553:"Obamacare Sign-Ups Decline to 10.2 Million as Some Don't Pay"
2067:
NYT-Steven Rattner-2017: The Year in Charts-December 29, 2017
104:
costs provided the balance. Beneficiaries numbered 2 million
2709:
Provisions of the Patient Protection and Affordable Care Act
844:"Congress weighing laws to let people keep health insurance"
2755:
Authority for Mandate Delay Act (H.R. 2667; 113th Congress)
1050:
Cox, Cynthia; Claxton, Gary; Levitt, Larry (June 6, 2013).
2599:
Codification in U.S. Code is generally at 42 U.S.C. 18001
63:
million more risked seeing their current plans cancelled.
320:
decline as income rose: 2% of those above 400% enrolled.
271:" on expensive insurance plans by two years, until 2020.
989:"How To Explain The Obamacare Ruling To A Five-Year-Old"
2803:
National Federation of Independent Business v. Sebelius
1519:"Burden of Health-Care Costs Moves to the Middle Class"
731:
Obama blames 'bad apple' insurers for canceled coverage
181:
attempted to explain the reductions. Reasons included:
115:
National Federation of Independent Business v. Sebelius
2177:"Aetna exiting all ACA insurance marketplaces in 2018"
2150:"Aetna CEO: Obamacare markets are in a 'death spiral'"
1921:
Abelson, Reed; Sanger-katz, Margot (August 19, 2016).
1225:"White House claims success on HealthCare.gov repairs"
2429:"House Passes Bill to Repeal Obamacare: Live Updates"
1272:
Holland, Steve; Rampton, Roberta (November 6, 2013).
1180:"Obama drops long-term health care program - CNN.com"
821:"Obama apologizes to Americans who lost health plans"
688:"After the big Obamacare apology: where things stand"
438:
Murray—Alexander Individual Market Stabilization Bill
432:
Murray—Alexander Individual Market Stabilization Bill
267:
The December spending bill delayed the onset of the "
164:
Community Living Assistance Services and Supports Act
2703:
Health Care and Education Reconciliation Act of 2010
629:"A Town Hall, and a Health Care Model, in Green Bay"
474:"Long Time Coming: Why Health Reform Finally Passed"
123:
did so, although some later accepted the expansion.
37:
Health Care and Education Reconciliation Act of 2010
3083:
3043:
3031:
2812:
2773:
2732:
2687:
2611:
Full text, summary, background, provisions and more
1578:"December 31, 2015 Effectuated Enrollment Snapshot"
1407:"Probe exposes flaws behind HealthCare.gov rollout"
611:"Top court upholds healthcare law in Obama triumph"
3142:Healthcare reform legislation in the United States
1991:"Next president faces possible ObamaCare meltdown"
1341:"Slowdown in Rise of Healthcare Costs May Persist"
2370:Sanger-katz, Margot; Abelson, Reed (2017-06-13).
1685:"Aetna to Drop Some Affordable Care Act Markets"
1672:. Federal Reserve Bank of New York. August 2016.
1200:. LifeHealthPro. January 2, 2013. Archived from
1078:"Some Bad News About Obamacare That Isn't Bogus"
157:delay the implementation of the employer mandate
3132:21st-century controversies in the United States
3060:America's Affordable Health Choices Act of 2009
2613:, via Democratic Policy Committee (Senate.gov)
2548:Thomas Kaplan; Robert Pear (17 October 2017).
2531:"Where the states stand on Medicaid expansion"
2359:. Congressional Budget Office. March 13, 2017.
2076:
2074:
1957:"The Unstable Economics in Obama's Health Law"
1744:"Humana pulling out of many Obamacare markets"
1597:"How the White House lost on the Cadillac Tax"
1135:"Options Expand for Affordable Long-Term Care"
913:"Report: Medicare's drug coverage gap shrinks"
2665:
1334:
1332:
8:
2765:Patient-Centered Outcomes Research Institute
2218:: CS1 maint: multiple names: authors list (
1441: (United States Supreme Court 2014).
1298:. Centers for Medicare and Medicaid Services
2699:Patient Protection and Affordable Care Act
2695:Patient Protection and Affordable Care Act
2672:
2658:
2650:
2637:Patient Protection and Affordable Care Act
2617:Patient Protection and Affordable Care Act
2200:Coombs, Dan Mangan, Bertha (May 3, 2017).
1405:Alonso-Zaldivar, Ricardo (July 31, 2014).
1099:. United States Department of the Treasury
869:"History of the Affordable Care Act (ACA)"
84:enrolled at a $ 28,994 cost per enrollee.
18:Patient Protection and Affordable Care Act
1388:"The Facts Are In and Paul Ryan Is Wrong"
538:
489:
3172:Acts of the 111th United States Congress
3162:United States federal health legislation
1792:Chakraborty, Barnini (August 10, 2016).
1276:. The Christian Science Monitor. Reuters
1251:"Rough Obamacare rollout: 4 reasons why"
3091:Health care reform in the United States
2505:O'Brien, Elizabeth (December 2, 2017).
2354:"American Healthcare Act Cost Estimate"
1683:Mathews, Anna Wilde (August 16, 2016).
1517:Sussman, Anna Louie (August 26, 2016).
1480:Sanger-Katz, Margot (August 19, 2016).
863:
861:
464:
3055:Affordable Health Care for America Act
2211:
1512:
1510:
1475:
1473:
1319:"More Skin in the Game – for Seniors?"
407:United States House of Representatives
2760:Contraceptive mandate (United States)
2280:
2278:
2171:
2169:
472:Oberlander, Jonathan (June 1, 2010).
35:on March 23, 2010. Together with the
7:
2962:New Mexico Health Insurance Exchange
2519:from the original on April 29, 2022.
2285:Mathews, Anna Wilde (June 6, 2017).
2124:Morton, Victor (February 14, 2017).
1989:Mali, Meghashyam (August 11, 2016).
1160:Carney, Timothy (February 28, 2011)
523:"The Affordable Care Act at 5 Years"
1895:Goldstein, Amy (October 14, 2016).
1451:Adler, Jonathan A. (July 3, 2014).
1223:Kennedy, Kelly (December 1, 2013).
1031:Cohn, Jonathan (February 5, 2013).
1014:"A Cruel Blow to American Families"
934:Liptak, Adam (September 30, 2012).
882:Enzi, Michael B. (August 2, 2011).
2479:Hatch, Orrin (December 20, 2017).
842:Schoof, Renee (November 8, 2013).
769:Weigel, David (November 8, 2013).
605:Vicini, James; Stempel, Jonathan;
409:voted to repeal the ACA using the
139:A June 2013, study found that the
14:
2902:Illinois Health Benefits Exchange
2328:Groppe, Maureen (June 21, 2017).
1820:Tracer, Zachary (2 August 2016).
1621:. Associated Press. June 30, 2016
1595:COOK, NANCY (December 16, 2015).
1317:Cohn, Jonathan (April 12, 2011).
743:Sealover, Ed (November 8, 2013).
355:Newly elected Louisiana Governor
229:to review premium increases, the
1717:Nussbaum, Alex (March 4, 2015).
1386:Chait, Jonathan (May 10, 2013).
1367:Chait, Jonathan (May 29, 2013).
1296:"Statistics, Trends and Reports"
733:, Reuters.com, October 30, 2013.
411:American Health Care Act of 2017
207:Government Accountability Office
55:Existing individual health plans
2750:Physician Payments Sunshine Act
2632:Statute Compilations collection
2453:Epstein, Reid J. (5 May 2017).
1869:Zdechlik, Mark (24 June 2016).
1551:Tracer, Zachary (2 June 2015).
1249:Cohen, Tom (October 23, 2013).
1076:Cohn, Jonathan (July 2, 2013).
527:New England Journal of Medicine
185:Higher unemployment due to the
2403:Tracer, Zachary (2017-02-15).
1369:"Yuval Levin Dissembles Madly"
1133:Span, Paula (March 29, 2010).
1033:"Not-So-Universal Health Care"
1:
2814:Health insurance marketplaces
2099:Coombs, Bertha (2017-02-14).
1339:Lowrey, Annie (May 7, 2013).
1198:"Watchdogs: CLASS still dead"
418:Tax Cuts and Jobs Act of 2017
120:
39:amendment, it represents the
3065:America's Healthy Future Act
2714:Health insurance marketplace
1955:Ip, Greg (August 17, 2016).
1719:"Health Insurance Exchanges"
823:. Fox News. November 8, 2013
26:111th United States Congress
3022:Washington Healthplanfinder
2852:Connect for Health Colorado
2306:Arp, Jessica (2017-06-21).
584:. Oxford University Press.
452:Congressional Budget Office
328:The law is designed to pay
3188:
3157:Presidency of Barack Obama
3032:Federal insurance exchange
2932:Health Insurance Connector
2922:Maryland Health Connection
2824:, an option for all states
2257:Luhby, Tami (2017-05-24).
968:. Kaiser Family Foundation
435:
2832:Arkansas Health Connector
2775:Constitutional challenges
2740:Essential health benefits
911:RICARDO ALONSO-ZALDIVAR.
491:10.1377/hlthaff.2010.0447
3152:Internal Revenue Service
2016:Kaiser Family Foundation
1056:Kaiser Family Foundation
793:"Obamacare: The debacle"
168:long-term care insurance
155:announced that it would
133:Internal Revenue Service
3047:from the 111th Congress
2882:Hawaii Health Connector
2292:The Wall Street Journal
749:Denver Business Journal
690:. CNN. November 8, 2013
28:and signed into law by
3045:Other reform proposals
3012:Vermont Health Connect
2784:Burwell v. Hobby Lobby
2719:Contraceptives mandate
1850:. The Arizona Republic
1433:Burwell v. Hobby Lobby
712:. CNN. 7 November 2013
540:10.1056/NEJMhpr1503614
372:
215:Burwell v. Hobby Lobby
205:On July 30, 2014, the
41:U.S. healthcare system
3147:Internal Revenue Code
3070:Healthy Americans Act
2724:Executive Order 13535
2603:To read it, start at
370:
151:On July 2, 2013, the
131:In January 2013, the
3075:Medicare for All Act
2645:US Statutes at Large
2130:The Washington Times
946:on November 14, 2012
891:United States Senate
153:Obama Administration
3167:Omnibus legislation
3127:Affordable Care Act
2681:Affordable Care Act
2537:. February 6, 2019.
2088:. February 3, 2017.
1961:Wall Street Journal
1689:Wall Street Journal
1523:Wall Street Journal
1186:. October 17, 2011.
1167:Washington Examiner
1020:. February 2, 2013.
871:. October 22, 2014.
187:2008–2010 recession
2972:NY State of Health
2952:Nevada Health Link
2842:Covered California
2745:Premium tax credit
2554:The New York Times
2376:The New York Times
2048:on August 25, 2016
1927:The New York Times
1486:The New York Times
1457:The New York Times
1346:The New York Times
1204:on August 12, 2015
1140:The New York Times
1018:The New York Times
940:The New York Times
915:. Associated Press
801:. November 2, 2013
373:
3114:
3113:
2892:Your Health Idaho
2790:Coons v. Geithner
2334:Indianapolis Star
2310:. Channel3000.com
1584:. March 11, 2016.
987:Walton, Alice G.
660:Jacobson, Louis.
647:National Archives
533:(25): 2451–2458.
400:Molina Healthcare
335:Kaiser Foundation
3179:
2862:Access Health CT
2674:
2667:
2660:
2651:
2582:
2581:
2579:
2578:
2564:
2558:
2557:
2545:
2539:
2538:
2527:
2521:
2520:
2502:
2496:
2495:
2493:
2491:
2476:
2470:
2469:
2467:
2465:
2450:
2444:
2443:
2441:
2439:
2425:
2419:
2418:
2416:
2415:
2400:
2394:
2393:
2391:
2390:
2367:
2361:
2360:
2358:
2350:
2344:
2343:
2341:
2340:
2325:
2319:
2318:
2316:
2315:
2303:
2297:
2296:
2282:
2273:
2272:
2270:
2269:
2254:
2248:
2247:
2245:
2244:
2238:Business Insider
2230:
2224:
2223:
2217:
2209:
2197:
2191:
2190:
2188:
2187:
2173:
2164:
2163:
2161:
2160:
2146:
2140:
2139:
2137:
2136:
2121:
2115:
2114:
2112:
2111:
2096:
2090:
2089:
2078:
2069:
2064:
2058:
2057:
2055:
2053:
2044:. Archived from
2034:
2028:
2027:
2025:
2023:
2008:
2002:
2001:
1999:
1997:
1986:
1980:
1979:
1977:
1975:
1952:
1946:
1945:
1943:
1941:
1918:
1912:
1911:
1909:
1907:
1892:
1886:
1885:
1883:
1881:
1866:
1860:
1859:
1857:
1855:
1846:Alltucker, Ken.
1843:
1837:
1836:
1834:
1832:
1817:
1811:
1810:
1808:
1806:
1789:
1783:
1782:
1780:
1778:
1767:
1761:
1760:
1758:
1756:
1740:
1734:
1733:
1731:
1729:
1714:
1708:
1707:
1705:
1703:
1680:
1674:
1673:
1671:
1663:
1657:
1656:
1654:
1652:
1637:
1631:
1630:
1628:
1626:
1615:
1609:
1608:
1606:
1604:
1592:
1586:
1585:
1574:
1568:
1567:
1565:
1563:
1548:
1542:
1541:
1539:
1537:
1514:
1505:
1504:
1502:
1500:
1477:
1468:
1467:
1465:
1463:
1448:
1442:
1436:
1428:
1422:
1421:
1419:
1417:
1402:
1396:
1395:
1383:
1377:
1376:
1364:
1358:
1357:
1355:
1353:
1336:
1327:
1326:
1323:The New Republic
1314:
1308:
1307:
1305:
1303:
1292:
1286:
1285:
1283:
1281:
1269:
1263:
1262:
1260:
1258:
1246:
1240:
1239:
1237:
1235:
1220:
1214:
1213:
1211:
1209:
1194:
1188:
1187:
1176:
1170:
1158:
1152:
1151:
1149:
1147:
1130:
1124:
1123:
1122:. 2014 TNT 28–1.
1115:
1109:
1108:
1106:
1104:
1092:
1086:
1085:
1082:The New Republic
1073:
1067:
1066:
1064:
1062:
1047:
1041:
1040:
1037:The New Republic
1028:
1022:
1021:
1010:
1004:
1003:
1001:
999:
984:
978:
977:
975:
973:
962:
956:
955:
953:
951:
942:. Archived from
931:
925:
924:
922:
920:
908:
902:
901:
899:
897:
888:
879:
873:
872:
865:
856:
855:
853:
851:
839:
833:
832:
830:
828:
817:
811:
810:
808:
806:
789:
783:
782:
780:
778:
766:
760:
759:
757:
755:
740:
734:
728:
722:
721:
719:
717:
706:
700:
699:
697:
695:
684:
678:
677:
675:
673:
665:
657:
651:
650:
644:
642:
625:
619:
618:
609:(28 June 2017).
602:
596:
595:
575:
569:
568:
542:
518:
512:
511:
493:
484:(6): 1112–1116.
469:
357:John Bel Edwards
94:guaranteed issue
3187:
3186:
3182:
3181:
3180:
3178:
3177:
3176:
3117:
3116:
3115:
3110:
3079:
3046:
3039:
3027:
3002:HealthSource RI
2808:
2796:King v. Burwell
2769:
2728:
2683:
2678:
2596:
2591:
2586:
2585:
2576:
2574:
2566:
2565:
2561:
2547:
2546:
2542:
2529:
2528:
2524:
2504:
2503:
2499:
2489:
2487:
2478:
2477:
2473:
2463:
2461:
2452:
2451:
2447:
2437:
2435:
2427:
2426:
2422:
2413:
2411:
2402:
2401:
2397:
2388:
2386:
2369:
2368:
2364:
2356:
2352:
2351:
2347:
2338:
2336:
2327:
2326:
2322:
2313:
2311:
2305:
2304:
2300:
2284:
2283:
2276:
2267:
2265:
2256:
2255:
2251:
2242:
2240:
2232:
2231:
2227:
2210:
2199:
2198:
2194:
2185:
2183:
2181:Washington Post
2175:
2174:
2167:
2158:
2156:
2148:
2147:
2143:
2134:
2132:
2123:
2122:
2118:
2109:
2107:
2098:
2097:
2093:
2080:
2079:
2072:
2065:
2061:
2051:
2049:
2036:
2035:
2031:
2021:
2019:
2018:. November 2016
2010:
2009:
2005:
1995:
1993:
1988:
1987:
1983:
1973:
1971:
1954:
1953:
1949:
1939:
1937:
1920:
1919:
1915:
1905:
1903:
1901:Washington Post
1894:
1893:
1889:
1879:
1877:
1868:
1867:
1863:
1853:
1851:
1845:
1844:
1840:
1830:
1828:
1819:
1818:
1814:
1804:
1802:
1791:
1790:
1786:
1776:
1774:
1769:
1768:
1764:
1754:
1752:
1742:
1741:
1737:
1727:
1725:
1716:
1715:
1711:
1701:
1699:
1682:
1681:
1677:
1669:
1665:
1664:
1660:
1650:
1648:
1639:
1638:
1634:
1624:
1622:
1617:
1616:
1612:
1602:
1600:
1594:
1593:
1589:
1576:
1575:
1571:
1561:
1559:
1550:
1549:
1545:
1535:
1533:
1516:
1515:
1508:
1498:
1496:
1479:
1478:
1471:
1461:
1459:
1450:
1449:
1445:
1430:
1429:
1425:
1415:
1413:
1404:
1403:
1399:
1385:
1384:
1380:
1366:
1365:
1361:
1351:
1349:
1338:
1337:
1330:
1316:
1315:
1311:
1301:
1299:
1294:
1293:
1289:
1279:
1277:
1271:
1270:
1266:
1256:
1254:
1248:
1247:
1243:
1233:
1231:
1222:
1221:
1217:
1207:
1205:
1196:
1195:
1191:
1178:
1177:
1173:
1159:
1155:
1145:
1143:
1132:
1131:
1127:
1120:Tax Notes Today
1117:
1116:
1112:
1102:
1100:
1094:
1093:
1089:
1075:
1074:
1070:
1060:
1058:
1049:
1048:
1044:
1030:
1029:
1025:
1012:
1011:
1007:
997:
995:
986:
985:
981:
971:
969:
964:
963:
959:
949:
947:
933:
932:
928:
918:
916:
910:
909:
905:
895:
893:
886:
881:
880:
876:
867:
866:
859:
849:
847:
841:
840:
836:
826:
824:
819:
818:
814:
804:
802:
791:
790:
786:
776:
774:
768:
767:
763:
753:
751:
742:
741:
737:
729:
725:
715:
713:
708:
707:
703:
693:
691:
686:
685:
681:
671:
669:
663:
659:
658:
654:
640:
638:
627:
626:
622:
604:
603:
599:
592:
577:
576:
572:
520:
519:
515:
471:
470:
466:
461:
444:Lamar Alexander
440:
434:
426:
365:
353:
344:
326:
298:
289:
280:
249:
221:Wheaton College
203:
129:
110:
90:
77:
57:
24:enacted by the
22:federal statute
12:
11:
5:
3185:
3183:
3175:
3174:
3169:
3164:
3159:
3154:
3149:
3144:
3139:
3134:
3129:
3119:
3118:
3112:
3111:
3109:
3108:
3103:
3098:
3093:
3087:
3085:
3081:
3080:
3078:
3077:
3072:
3067:
3062:
3057:
3051:
3049:
3041:
3040:
3037:HealthCare.gov
3035:
3033:
3029:
3028:
3026:
3025:
3015:
3005:
2995:
2985:
2975:
2965:
2955:
2945:
2935:
2925:
2915:
2905:
2895:
2885:
2875:
2872:DC Health Link
2865:
2855:
2845:
2835:
2825:
2822:HealthCare.gov
2818:
2816:
2810:
2809:
2807:
2806:
2799:
2792:
2787:
2779:
2777:
2771:
2770:
2768:
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2752:
2747:
2742:
2736:
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2730:
2729:
2727:
2726:
2721:
2716:
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2706:
2691:
2689:
2685:
2684:
2679:
2677:
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2669:
2662:
2654:
2648:
2647:
2634:
2614:
2608:
2595:
2592:
2590:
2589:External links
2587:
2584:
2583:
2559:
2540:
2522:
2497:
2471:
2445:
2420:
2395:
2362:
2345:
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2192:
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2070:
2059:
2029:
2003:
1981:
1947:
1913:
1887:
1861:
1838:
1812:
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1762:
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1723:Bloomberg View
1709:
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903:
874:
857:
834:
812:
784:
761:
735:
723:
701:
679:
652:
637:. 11 June 2009
634:whitehouse.gov
620:
607:Biskupic, Joan
597:
590:
570:
513:
478:Health Affairs
463:
462:
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457:
436:Main article:
433:
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235:risk corridors
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175:HealthCare.gov
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2409:Bloomberg.com
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2207:
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2182:
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2030:
2017:
2013:
2007:
2004:
1992:
1985:
1982:
1970:
1966:
1962:
1958:
1951:
1948:
1936:
1932:
1928:
1924:
1917:
1914:
1902:
1898:
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1888:
1876:
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