Thank you, Chairwoman Maloney, Ranking Member Comer, and Members of the Committee, for this invitation to testify today on pathways to universal coverage in the United States. My comments will focus on the national gains in health insurance coverage since the passage of the Affordable Care Act (ACA), the effects of the pandemic and COVID-19 relief efforts on coverage, and potential policy levers to cover the remaining uninsured and lower consumer costs.
ACA Reduced the Number of Uninsured Americans and Lowered Financial Barriers to Care
The ACA brought sweeping change to the U.S. health system, expanding comprehensive, affordable health insurance to millions of lower-and middle-income Americans and making it possible for anyone with health problems to buy health insurance by banning insurers from denying people coverage or charging them more because of preexisting conditions.
The number of uninsured people in the United States has fallen by nearly half since the ACA was signed into law, dropping from a historical peak of 48.6 million people in 2010 to a low of about 28 million in 2016. There was a slight uptick in the number of uninsured after that through 2020.
A large body of research on the effects of the ACA show conclusively that the law lowered financial barriers to care and improved people’s ability to afford health insurance and get needed health care.