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ACA Overview

By April 26, 2016August 22nd, 2018


The Affordable Care Act (ACA) has brought significant changes to the health care industry. The article below summarizes some of the main trends that have resulted from the ACA over the past few years.

Insured Rates

Since the passage of the ACA, 20 million people have gained health insurance, according to the Obama administration. In 2009 (before the ACA), nearly 49 million people (15.7 % of the U.S. population) were uninsured. According to a 2015 study by the U.S. Census Bureau, the uninsured rate has dropped to 9.2 %—the lowest amount in 50 years.

Employer Coverage

Despite initial concerns that many employers would drop health coverage as a result of the ACA, most companies have continued to provide health insurance. According to a study by the Kaiser Family Foundation, the percentage of adults under the age of 65 with employer-sponsored health insurance has remained stable for the past five years.

Many companies view health insurance as an important recruitment and retention tool, especially as the economy has improved. Employers receive a sizeable tax break for providing health insurance to their employees and while employers’ perceptions could change if health care prices increase dramatically, it appears that employer-sponsored coverage will continue to be offered by the majority of employers in the near future.


Approximately 87% of people enrolled in the Marketplace receive a premium tax subsidy. On average, subsidies are $272 per month or $3,264 per year. According to the IRS, 2.7 million taxpayers claimed approximately $9 billion in subsidies when filing their taxes in 2015.

However, about 1.6 million of those taxpayers ultimately had to pay money back to the government because their actual incomes were higher than they had projected when they signed up for a plan on the Marketplace. The average amount repaid was about $800.

Tax Penalties

Approximately 7.5 million Americans paid a penalty for not having health insurance in 2014—the first year in which most Americans were mandated to have coverage under the ACA. The Obama administration initially expected only 2-4 % of taxpayers to pay the penalty, but in reality, it was about 6%.

The average penalty paid among these individuals was $200 per person, and the IRS collected about $1.5 billion from these fines in 2015. The Treasury Department notes, though, that 300,000 people who paid the penalty were likely eligible for a health coverage exemption. These individuals will have the option of filing an amended tax return.

It is possible that tax penalty numbers could decline, since the penalty for not having coverage in 2016 is higher, which may prompt more individuals to purchase health insurance.

These are just some of the ways in which the ACA has affected the health care industry. Given the novelty of the Marketplace and the constantly evolving nature of the health care industry, these trends are subject to change. For more information on health care reform, contact The Flanders Group at 800-462-6435.