ObamaCare vs. TrumpCare

ObamaCare vs. TrumpCare in 10 Charts

1. The Affordable Care Act (ACA) Has Provided Affordable Health Insurance Coverage to Millions

Thanks to the ACA’s new Health Insurance Marketplaces, Medicaid expansion, and other provisions, the uninsured rate across all ages and income levels has fallen to the lowest level on record, giving Americans health and financial security.

SOURCE: PETERSON INSTITUTE FOR INTERNATIONAL ECONOMICS

2. Americans Have Gained Protections from Risk of Devastating Health Care Bills

Before the ACA, roughly 20 percent of workers had health insurance policies that included a cap on benefits, which exposed workers to the risk of devastating health care costs. The ACA banned these caps on benefits, protecting millions of workers and their families.

SOURCE: PETERSON INSTITUTE FOR INTERNATIONAL ECONOMICS

3. Health Care Cost Growth Has Slowed

Health care prices have risen at the slowest rate in fifty years since the ACA was enacted, and projections of health care expenditures have fallen sharply. The ACA included reforms to help move the health care system to pay for services based on quality rather than quantity.

SOURCE: PETERSON INSTITUTE FOR INTERNATIONAL ECONOMICS

4. Workers Have Experienced Slower Growth in Health Coverage Costs

The majority of working age Americans get their health insurance coverage through an employer. Cost growth of premiums and out-of-pocket costs for workers and their families are significantly lower since the passage of the ACA than in the decade before.

SOURCE: PETERSON INSTITUTE FOR INTERNATIONAL ECONOMICS

5. The ACA Is (Still) Working: No Increase in 2017 Health Insurance Marketplace Premiums After Tax Credits

Thanks to the ACA’s tax credits which rise along with premiums, 83 percent of consumers buying health plans through HeatlhCare.gov are paying $0 more in premiums in 2017 compared to 2016.

SOURCE: U.S. DHHS, CENTERS FOR MEDICARE & MEDICAID SERVICES

6. Is TrumpCare Health Reform or Tax Reform?

The American Health Care Act (AHCA) would transfer federal funding from helping low- and middle-income Americans get health care to tax breaks for high-income Americans and health care special interests.

SOURCE: CONGRESSIONAL BUDGET OFFICE AND JOINT COMMITTEE ON TAXATION

7. Low-Income, Older—and Eventually All—Americans Who Get Premium Tax Credits Would Pay More Under TrumpCare

The AHCA replaces the ACA’s income- and premium-based tax credits with fixed-dollar credits that partially adjust for age and increase with general inflation rather than health inflation. By no longer adjusting premium tax credits for income, it would cause the average enrollee with income below 200 percent of poverty (and higher in many cases) to pay several hundred to several thousand more for the same health coverage. It would also not adequately adjust for age, causing older Americans to pay more for coverage. And the slow growth of the credit means that, over time, premiums for young adults would also be higher under the AHCA versus the ACA.

SOURCE: THE CENTURY FOUNDATION

8. People in Rural and High-Cost States Would Pay More Under TrumpCare

By no longer adjusting premium tax credits based on the local price of health insurance, the AHCA would dramatically decrease the premium tax credits in rural (and other) states with high health care costs.

SOURCE: CENTER ON BUDGET AND PRIORITIES

9. TrumpCare Would Cap Medicaid Funding, Putting Essential Care at Risk

The AHCA includes a policy unrelated to the ACA: a per-capita cap on federal Medicaid spending (in addition to its repeal of the ACA’s Medicaid coverage expansion). The funding cap would alter Medicaid is financed. By shifting financial risks to states, the AHCA could cause reduced benefits for millions of children, adults, elderly, and individuals with disabilities.

SOURCE: KAISER FAMILY FOUNDATION

10. TrumpCare Would Cause Uninsured Rate to Spike to Pre-ObamaCare Level

The Congressional Budget Office (CBO) estimates that 24 million Americans would lose health insurance coverage in 2026 under the AHCA—making the uninsured rate higher than it was when the ACA was enacted.

SOURCE: CENTER ON BUDGET AND POLICY PRIORITIES


All original charts and sourcing can be downloaded in “Health Care: Obama Officials Look Back at the ACA and the Path Forward Chart Pack.”

Jeanne Lambrew, Senior Fellow

Jeanne Lambrew, PhD, is a senior fellow at The Century Foundation and an adjunct professor at the NYU Wagner Graduate School of Public Service. Her writing, research, and teaching focus on policies to improve health care access, affordability, and quality.

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