The Affordable Care Act has enabled millions of Americans to obtain affordable health insurance, with a record 14.5 million people signing up during the most recent open enrollment period. 

On Wednesday, the U.S. Department of Health and Human Services celebrated the 12th anniversary of the ACA by detailing its many successes. According to the “State of the ACA Report,” released by the Centers for Medicare & Medicaid Services, the act is in its strongest position since it became law in 2010. It has led to historically low insurance premiums and record-breaking sign-ups through the federal health insurance marketplace.A doctor examines a patient 

The ACA has fundamentally changed America’s health care system by enabling millions of people to afford health insurance, which has improved health equity, the report said. Since the passage of the law, the number of uninsured people has declined from an estimated 50 million in 2009 to 29 million in 2021.

Recent gains have come in part because of the American Rescue Plan Act, which included ACA tax-credit subsidies and low premiums on marketplace insurance plans. Thanks to ARPA subsidies, many enrollees pay premiums that are over 50% lower, the report said. And nearly 3 million more Americans are receiving tax credits this year to pay for their premium costs.

“On the 12th Anniversary of the ACA, it is clear that the Affordable Care Act and the American Rescue Plan are working to expand access to health care coverage and have been critical to advancing health equity,” CMS Administrator Chiquita Brooks-LaSure, MPP, said in a news release.  

Of critical benefit to Americans has been the ACA rule that prevents health insurers from discriminating against consumers who have preexisting health conditions, noted HHS Secretary Xavier Becerra, JD.

“Today, there are 133 million Americans who don't have to worry again about an insurance company saying, ‘Oh, yeah, we'd cover you, except you have asthma,’” Becerra said during a Wednesday anniversary event. “It also means that a woman who might be of childbearing age can no longer be told that she's got a preexisting medical condition because she is childbearing.”

The ACA has also allowed young people to stay on their parents’ insurance plan up to age 26, which has been a cost-effective boost, Becerra said.

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