Health Insurance Coverage Crucial for Access, Outcomes, and Financial Security
As the federal government shutdown ends, the debate over extending enhanced premium tax credits (ePTCs) under the Affordable Care Act (ACA) continues with new perspectives emerging.
Notably, there is a shift towards proposals suggesting direct cash payments to individuals instead of continuing ePTCs to subsidize premiums. These ideas propose that individuals might manage their health care better without traditional insurance, despite extensive evidence indicating that health insurance significantly improves health outcomes and financial security. Health care costs remain high, exemplified by emergency treatments costing several thousand dollars, underscoring the value of comprehensive insurance coverage.
Earlier in the year, various policy analysts, think tanks, and interest groups argued that health insurance inflates health care costs without improving population health, advocating for models where patients pay out-of-pocket and government roles are limited to promoting healthy behaviors and innovation. These arguments may have influenced legislation such as H.R. 1, which has already led to millions losing coverage. The U.S. health care system faces challenges including market consolidation, increased premiums and provider prices, delays in accessing care, and administrative barriers like prior authorizations. However, removing insurance access contradicts evidence showing health coverage increases use of primary, preventive, and chronic care services, enhancing population health and equity for underserved groups.
Research spanning decades consistently demonstrates insurance expansions correlate with improved health outcomes—such as reduced mortality and better management of chronic diseases—and improved financial protection against high medical costs.
Specific vulnerable populations, including those with chronic illnesses, immigrant families, and traditionally marginalized communities, benefit notably from coverage expansions. Financially, insurance shields families from catastrophic health expenses, with studies showing declines in medical debt and severe health care costs following ACA implementation. Despite imperfections like deductibles, health insurance remains critical for access, health improvement, and economic stability, and reductions in federal insurance support risk deteriorating the health and financial well-being of millions of Americans.