Problems With The Affordable Care Act

The Affordable Care Act, also referred to as ACA or Obamacare, was signed into law by President Barack Obama in 2010. The act was a significant overhaul of the U.S. healthcare system, reducing the amount of uncompensated care the average family pays. Obamacare initially required everyone to have health insurance and offered cost assistance to those who could not independently afford a plan.

The original coverage requirement in Obamacare included a tax penalty for those that did not purchase a health insurance plan—known as the individual mandate. The penalties were designed to offset the cost of paying for people's health care without health insurance due to hardship situations or other exemptions.

In December 2017, the Trump administration passed a tax bill repealing the individual mandate. This repeal is still in effect in 2020, eliminating the fine for those without health insurance plans in most states. A few states do have their mandates in 2020, including California, Connecticut, Hawaii, Maryland, Minnesota, Rhode Island, and Washington.

Challenges Of Affordable Care Act

The very day President Trump was sworn in — Jan. 20, 2017 — he signed an executive order instructing administration officials "to waive, defer, grant exemptions from, or delay" implementing parts of the Affordable Care Act, while Congress got ready to repeal and replace President Obama's signature health law.

Months later, repeal and replace didn't work, after the late Sen. John McCain's dramatic thumbs down on a crucial vote (Trump still frequently mentions this moment in his speeches and rallies, including in his recent speech on Medicare).

After that, the president and his administration shifted to a piecemeal approach as they tried to take apart the ACA. "ObamaCare is a broken mess," the president tweeted in the fall of 2017 after repeal in Congress had failed. "Piece by piece, we will now begin the process of giving America the great HealthCare it deserves!"

Two years later, what has his administration done to change the ACA, and who's been affected?

Below are five of the most significant changes to the federal health law under President Trump.

1. Individual mandate eliminated-The individual mandate is the requirement that all U.S. residents either have health insurance or pay the penalty.

2. States allowed adding "work requirements" to Medicaid

3. Cost-sharing reduction subsidies to insurers have ended

4. Access to short-term "skinny" plans has been expanded

5. Funds to facilitate sign-ups slashed

Problems With The Affordable Care Act 2020

What Are the Pros and Cons of the Affordable Care Act?

Here are a few of the often-debated Affordable Care Act pros and cons to weigh both sides of the ongoing debate.


Subsidies offer financial help.

Subsidies make purchasing health insurance less expensive for those who qualify. Also, the implementation of the 80/20 rule means 80% of your premium dollars is spent on healthcare instead of administrative costs.

Preventive care

All qualified health insurance plans must provide ten essential health benefits. These benefits include preventive care and wellness visits with no copay, deductible, or coinsurance.

No pre-existing condition denials

Insurance companies also cannot deny coverage for a pre-existing condition (unless your plan is grandfathered).

Medicaid is more inclusive for many.

For states that have chosen to expand their program, Medicaid coverage now includes uninsured Americans under 138% of the federal poverty level.

Dependents can stay under their parents’ plan longer.

Your children can be insured under your health plan until they are 26 years old.

No more limits

Limits on lifetime benefits have been completely banned, and annual limits phased out. (This does not include grandfathered plans).


The cost has not decreased for everyone.

Those who do not qualify for subsidies may find marketplace health insurance plans unaffordable. Customers may end up paying more for a plan that includes benefits, such as maternity care, that they may not need.

Loss of company-sponsored health plans

Some businesses may find it more cost-effective to let their employees purchase their insurance on the exchanges rather than provide employer-sponsored coverage.

Tax penalties

Before 2019, you could face large tax penalties if you were uninsured. The federal tax penalty no longer exists, but some states are now enacting health insurance mandates of their own.

Shrinking networks

Many insurance companies made their provider networks smaller to cut costs while implementing ACA requirements. This left customers with fewer providers that are “in-network.”

Shopping for coverage can be complicated.

Shopping for coverage can be complicated with limited enrollment periods, difficulties with the websites, and more coverage options.

Effects Of The Affordable Care Act 

The Patient Protection and Affordable Care Act – commonly referred to as the Affordable Care Act and also known as Obamacare – is a sweeping piece of legislation passed by the 111th Congress and signed into law by President Barack Obama in 2010.

The law was intended to improve the affordability – and quality – of health insurance in the United States.

The law included more than 1,000 pages of provisions intended to make coverage affordable for and accessible to millions of Americans who struggled to pay for individual coverage – many of whom could not buy individual coverage at any price due to pre-existing medical conditions. The law sharply reduced the number of uninsured Americans, although the uninsured rate has been creeping upwards under the Trump administration’s watch.

Affordable Care Act Problems And Solutions

Full Repeal Of Health Insurance Tax, Cadillac Tax, And Medical Device Tax

The spending deal will fully repeal three of the ACA’s most significant taxes: the health insurance tax, the Cadillac tax, and the medical device tax. Repeal of the health insurance tax would not take effect until 2021, meaning the tax—which has already been built in to many premiums for the 2020 plan year—will remain in effect for 2020. The Cadillac tax and medical device tax are repealed beginning in 2020.