The ACA used six Approaches to Cover the Uninsured

1. Expand Medicaid eligibility from 100 to 138 percent of the federal poverty level (FPL).

2. Impose an employer mandate requiring employers to offer their employees health insurance or pay a penalty.

3. Provide tax credits to small employers to incentivize them to buy insurance for their employees.

4. Impose an individual mandate to buy insurance or pay a penalty. 5. Permit dependent children up to age 26 to be included on their

parent’s insurance. 6. Provide income-related tax credits for use on newly established ACA

insurance exchanges to those with incomes between 138 and 400 percent of the FPL.

 

Overall, the ACA succeeded in reducing the number of uninsured from 41.1 million in 2013 to 27.5 million in 2016; 13.6 million gained insur- ance. The number of uninsured as a percentage of the nonelderly population decreased from 15.3 percent to 10.1 percent during this period. Based on administrative data, Medicaid enrollment increased by 13 million as of 2017, to 74 million, and the exchanges expanded to 9.1 million (2016) and 9.9 million by 2017.