The Affordable Care Act (ACA)

The Affordable Care Act (ACA)

The Affordable Care Act (ACA) has subsidies, which are tax credits that are given on a sliding scale to individuals whose net income ranges between 100% and 400% of the federal poverty level (FPL). The subsidies help to reduce the health insurance premium costs to individuals who may struggle to pay for health insurance (Liu et al., 2021). The subsidies come in two primary forms including the cost sharing reduction and premium tax credits subsidies. The most predominant ACA subsidy is the Medicaid. There are different criteria that are needed for one to qualify for ACA subsidies. One must be a citizen of US or legal resident, living in America currently, and not serving jail term. Households with income of between 100% and 400% FPL are also eligible for the subsidies.

According to Frean et al. (2017), ACA subsidies differ from Medicaid in several ways. In terms of coverage plans, Medicaid program is a government initiative provided to people and families earning low incomes, ACA subsidies are provided by the private insurance organizations. Concerning the beneficiaries of the programs, the Medicaid program strives to provide health insurance coverage to the older adults who are 65 years and above and the younger individuals with certain disabilities. On the other hand, the ACA subsidies seek to ensure that every citizen attains affordable health insurance coverage without considering the economic or social background. Moreover, Medicaid is given by the government to the eligible beneficiaries while ACA subsidies are purchased by individuals from the private companies that deal in health insurance.

References

Frean, M., Gruber, J., & Sommers, B. D. (2017). Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act. Journal of Health Economics, 53, 72-86. https://doi.org/10.1016/j.jhealeco.2017.02.004

Liu, C., Gotanda, H., Khullar, D., Rice, T., & Tsugawa, Y. (2021). The Affordable Care Act’s Insurance Marketplace Subsidies Were Associated With Reduced Financial Burden For US Adults: Study examines the ACA’s insurance marketplace subsidies and financial burden on US adults. Health Affairs, 40(3), 496-504. https://doi.org/10.1377/hlthaff.2020.01106