WASHINGTON (TNND) — One of the main sticking points between Republicans and Democrats in the ongoing government shutdown fight is the Affordable Care Act, specifically, whether federal subsidies that help pay for coverage should be extended.
Sen. Rick Scott claims the only reason the Affordable Care Act (ACA) is still standing is because the federal government keeps pumping billions of dollars into insurance companies. And while that might sound exaggerated, the numbers actually back him up.
Since the ACA took effect in 2014, the federal government has spent around $800 billion through the Premium Tax Credit, a subsidy designed to help lower and middle-income Americans afford their monthly health insurance premiums, according to the Tax Foundation. These payments go directly to insurers on behalf of roughly 19 million Americans who qualify for discounted coverage in 2024, according to KFF.
So, why is the bill to taxpayers so high right now?
There are two main reasons. First, enrollment has exploded, growing from about 6 million people in 2014 to more than 20 million this year. Second, during the pandemic, Congress removed the old income cap, allowing people earning above 400% of the federal poverty level to still qualify for subsidies. That change made insurance more affordable for middle-class families but also expanded who’s eligible for government help.
In 2023, the federal government spent $111 billion on these subsidies, and that number is expected to top $120 billion this year, more than $200 billion in just two years, according to the Tax Foundation.
15 Years of the Affordable Care Act: What’s Changed?
It’s been 15 years since President Obama signed the Affordable Care Act into law, better known as Obamacare.
The law’s original goal was simple: make healthcare more affordable and accessible. Before the ACA, nearly 50 million Americans were uninsured, and people with preexisting conditions could be denied coverage. The ACA changed that — it expanded Medicaid, created online marketplaces, and provided subsidies to help people afford premiums.
According to the State Health Access Data Assistance Center, since the ACA’s coverage provisions went into effect in 2013, the number of people with health insurance has grown by more than 38 million, and the nation’s uninsured rate has nearly halved, from 14.4% in 2013 to 7.9% in 2023.
But that progress has come with a hefty price tag.
The cost of federal health insurance assistance has more than doubled since the pandemic. In total, since COVID, American taxpayers have spent roughly $440 billion on ACA subsidies.
Supporters say the spending is worth it, keeping healthcare within reach for millions. But critics argue it’s unsustainable, pointing out that taxpayers are footing the bill while premiums for people not getting subsidies remain high.
