--- title: 'Money Then & Now: The Affordable Care Act and the rising cost of health' description: The Affordable Care Act (ACA) expanded health insurance significantly but many still struggle to pay for rising health care costs. authors: - name: Amarilis Yera role: Writer url: https://money.com/author/amarilis-yera/ bio: Amarilis Yera is a former lead writer at Money, specializing in consumer credit and credit cards. Her work has been featured in MSN, Yahoo! Money, and Nasdaq. education: University of Puerto Rico-Mayagüez at_money_since: 2020 articles: 70 covers: - Health and Wellness - Banking - Business - Credit - Credit Cards - Economy and Politics - Identity Theft - Insurance - Lifestyle - Loans - Personal Finance - Pets - Professional Services - Shopping - Technology social: - https://www.linkedin.com/in/amarilis-yera/ former_staff: true - name: Taína Cuevas role: Lead Editor, Credit and Credit Cards url: https://money.com/author/taina-cuevas/ bio: Taína Cuevas is a former managing editor at Money, where she specialized in consumer credit, credit cards, and product reviews. She also oversaw Money's financial product compliance department, ensuring the publication provided up-to-date and accurate information. education: Franklin University Switzerland at_money_since: 2018 articles: 27 covers: - Health and Wellness - Banking - Business - Career Advice - Credit - Credit Cards - Debt - Housing - Identity Theft - Insurance - Investing - Lifestyle - Loans - Mortgages - Personal Finance - Pets - Professional Services - Shopping - Taxes - Technology former_staff: true editors: - name: Brad Tuttle role: Senior Editor url: https://money.com/author/brad-tuttle/ bio: Brad Tuttle is a former senior editor at Money with over 10 years’ experience covering a vast number of personal finance topics, including careers, cars, travel, budgeting, investing, insurance, credit cards, consumer psychology, real estate, banking, and shopping and deals. education: Columbia University School of Journalism, MS at_money_since: 2014 articles: 366 covers: - Health and Wellness - Banking - Business - Career Advice - Credit - Credit Cards - Economy and Politics - Education - Housing - Identity Theft - Insurance - Investing - Lifestyle - Loans - Mortgages - Personal Finance - Pets - Professional Services - Retirement - Shopping - Taxes - Technology social: - https://twitter.com/bradrtuttle - https://linkedin.com/in/brad-tuttle-834b225 former_staff: true - name: Jill Cornfield role: Deputy Editor url: https://money.com/author/jill-cornfield/ bio: 'Bio: Jill Cornfield is the deputy editor of Money. She''s also edited and written for Investopedia, CNBC and Bankrate.' education: Hunter College at_money_since: 2022 articles: 1 covers: - Health and Wellness - Banking - Business - Credit - Economy and Politics - Housing - Insurance - Investing - Loans - Mortgages - Personal Finance - Retirement - Taxes social: - https://twitter.com/jill_cornfield - https://www.linkedin.com/in/jillcornfield/ former_staff: true published: '2022-11-30T13:00:55.000Z' modified: '2022-11-30T17:38:31.000Z' section: Health and Wellness tags: - 50th anniversary - Money Archives - News word_count: 1184 canonical: https://money.com/money-then-now-the-affordable-care-act-and-the-rising-cost-of-health/ type: NewsArticle source: structured-blocks --- > **Disclosure:** We research all brands listed and may earn a fee from our partners. Research and financial considerations may influence how brands are displayed. Not all brands are included. [Learn more](https://money.com/page/disclaimer/). ![Split Screen Of President Obama in the gallery of the House Chamber on Sept. 9, 2009 On the Left And a photo of a stethoscope on top of a stack of cash On The Right](https://img.money.com/2022/10/Then-And-Now-2010-Obamacare.jpg) *We just launched [Money Archives](https://money.com/archives/), a new experience where we're digitizing decades of our print Money magazines. This is the fifth and final article in a series of stories that examine how personal finance — and our coverage of it — has evolved over time.* * * * Back in 2010, the entire country seemed to be focused on one thing: the enactment of a sweeping and deeply contentious piece of legislation by the name of the Patient Protection and Affordable Care Act, otherwise known as Obamacare. [In the May issue for that year](https://money.com/archives/2010s/2010/may/the-truth-about-health-care-reform/), Money took a deep dive into the intricacies of what became known as the ACA, analyzing its provisions and how it might achieve its ambitious goal of insuring nearly every American. Before the ACA, an estimated [16% of Americans](https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201106.htm#:~:text=In%202010%2C%20the%20percentage%20of%20persons%20uninsured%20at%20the%20time,\(Tables%201%20and%202\).) didn’t have health insurance. Insurers could deny coverage to anyone with a pre-existing condition and had a lot more leeway in canceling someone's plan if they got sick. Insurance companies also had the power to set annual or lifetime limits on how much they would spend on patients. The law essentially banned those practices. It also expanded Medicaid eligibility, granted tax credits to help pay for premiums and allowed young adults to stay on their parent's plans until age 26. All of this helped slash the uninsured rate, which was [8% in early 2022](https://www.hhs.gov/about/news/2022/08/02/new-hhs-report-shows-national-uninsured-rate-reached-all-time-low-in-2022.html#:~:text=The%20nation's%20uninsured%20rate%20declined,of%209.0%20percent%20in%202016.), a historical low. But, as we reported in our 2010 story, the ACA did not address some important issues, and the financial burden on patients stemming from high health care costs was chief among them. As we said in our story, "The huge increase in per-person spending on doctors, hospitals and pills'' was directly impacting both the government and people's budgets. Within the past two decades, health care costs have [risen higher and faster](https://www.axios.com/2022/08/25/health-prices-faster-private-sector-medicare) than almost any other industry, increasing around 110% since 2000. (Prices for all other consumer goods and services have risen 71% within the same period.) And, while insurance plans will cover a share of these costs, the portion that has to be paid by patients — including premiums, deductibles and even covered medications — can still be unaffordable for many. ## Staying healthy has never been more important ### Protect yourself and your loved ones with a comprehensive and affordable health insurance plan. Click your state to learn more. [View Rates](https://money.com/pr/ud9b374d7112?ap_referrer=%2Fmoney-then-now-the-affordable-care-act-and-the-rising-cost-of-health%2F) ### The price of health Cynthia Cox, vice president at the Kaiser Family Foundation (KFF), a nonprofit health care policy research organization, says that America’s health care system is better off in many ways because of the ACA. "People have more affordable coverage, and more people are covered,” says Cox. “But we're still, as a society, spending much more on health care than any other country does." said She notes that one of the main problems is that U.S. hospitals, doctors and pharmaceutical companies charge much higher prices for their services and products. While most countries can strictly regulate the prices health providers are allowed to charge, there is no such regulation here, and price negotiations between insurance companies and health care providers in the U.S. happen largely behind closed doors. This can lead to prices varying widely for patients with similar health insurance policies, even within the same hospital. A [2021 report](https://www.nytimes.com/interactive/2021/08/22/upshot/hospital-prices.html) from the New York Times found that a colonoscopy at the University of Mississippi Medical Center cost $2,144 if the patient had an Aetna plan, compared to $1,463 for a Cigna plan and $782 if the individual had no insurance at all. ## Get a Health Insurance policy that meets your wellness needs ### An affordable Health Insurance plan can cover any incident that might happen in the future. [View Rates](https://money.com/pr/ueb4827bfe5c?ap_referrer=%2Fmoney-then-now-the-affordable-care-act-and-the-rising-cost-of-health%2F) ### What we pay out of pocket Soaring health care costs are certainly reflected in how much customers are paying for health insurance premiums. Take, for example, the monthly premiums for a mid-tier plan for a 40-year-old, which [increased](https://www.kff.org/health-reform/state-indicator/marketplace-average-benchmark-premiums/?currentTimeframe=0&selectedDistributions=2014--2020--2021--2022&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D) from $273 in 2014 to $438 in 2022. Some states have experienced even more drastic changes: In Iowa, for example, the average rose from $253 to $502 in the same time period. Average monthly premium for a 40-year-old (all states)
2014 U.S. average$273
2022 U.S. average$438
Average monthly premium for a 40-year-old (Iowa)
2014 Iowa average$253
2022 Iowa average$502
From its inception, the ACA tried to offset the cost of premiums by providing tax credits, but only to those earning up to four times the federal poverty level. (That would be $54,360 for individuals and $111,000 for a family of four in 2022.) However, making even $10 over that threshold was disqualifying, which meant many middle-class households have not been eligible for a break. "Even if you would have to pay, say, 20% of your income on insurance, there was still no help available for you," mentioned Cox. The 2021 American Rescue Plan Act (ARP) temporarily suspended that income cutoff so that people earning more than four times the federal poverty level could qualify for assistance. This provision, which capped annual premium spending at no more than 8.5% of one’s income, was extended by the Biden administration through 2025. When it comes to out-of-pocket expenses, the ACA placed limits on how much a patient must pay under its plans. These limits, however, are high and are set to rise every year. For instance, in 2022, that maximum out-of-pocket maximum is set at $8,700 for an individual and $17,400 for a family. In 2023, that cap will be even higher — $9,100 for an individual and $18,200 for a family. ## A quality Health Insurance Plan can cover most unexpected incidents ### With a Health Insurance Plan that meets your needs while remaining affordable, you'll be good to go. Click below to find out more. [View Rates](https://money.com/pr/u2681ba02390?ap_referrer=%2Fmoney-then-now-the-affordable-care-act-and-the-rising-cost-of-health%2F) ### The ACA and the price of prescriptions The ACA established that health plans needed to include prescription drug coverage. Under its provisions, insurance companies had to cover at least [one drug in each category and class](http://washingtonpost.com/national/health-science/things-you-need-to-know-about-the-affordable-care-act-and-prescription-drugs--but-probably-dont/2013/12/09/c00054c4-5eba-11e3-95c2-13623eb2b0e1_story.html) from the official list of approved medications, and pharmaceutical companies had to offer increased rebates to lower the cost of Medicaid-covered drugs. However, in practice, the cost for the same medication varies significantly between plans and insurers, depending on required co-pays and coverage. And, as the price for prescription drugs rose, the financial burden on patients has increased. In 2022, Congress passed the Inflation Reduction Act (IRA), an attempt at regulating the price of prescription drugs. The law allows the government to negotiate costs for certain Medicare-eligible medications and cap out-of-pocket expenses for seniors. It also requires that companies pay Medicare rebates if they raise the price of their drugs faster than the pace of inflation. Because of the IRA’s provisions, the Department of Health and Human Services will negotiate prices for 10 drugs in 2023. This number will increase each year until 2029, when 60 drugs will be subject to negotiated prices. While this might seem limited, Cox considers this legislation a meaningful step toward drug price reform, especially since there's been such hesitation to regulate health care prices directly before. "I think there's starting to be a recognition that that's why our health care system is so unaffordable. It's because we don't have any of that regulation that other countries do," Cox suggested. "There's an even bigger challenge ahead that the new law only begins to tackle: figuring out how to get a grip on exploding health care costs. This law can't work in the long run otherwise." As we reported in Money's 2010 breakdown of the law, the price of health care was one problem the ACA did not — or perhaps could not — tackle. 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