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To the Editor:

The future of the Affordable Care Act (ACA) hinges on the outcome of this year’s presidential election.  Enacted into law in 2010, the ACA is designed to make healthcare coverage in this country more accessible and affordable. By all measures, it has succeeded in accomplishing these objectives: a record 50 million people – or one in seven Americans – have had ACA marketplace coverage at some point, according to a new government report. Closer to home, nearly 980,000 North Carolinians enrolled in a plan through the health care marketplace in 2024.

Yet, despite the ACA’s ever-growing popularity and success, Republican presidential nominee Donald Trump sought to undermine the law during his administration as well as supported efforts by Republicans in Congress to overturn it. He never issued his own replacement plan, notwithstanding repeated promises to do so. More recently, during the debate with Vice President Kamala Harris, Trump claimed that he has “concepts of a plan” to replace the ACA, which “you’ll be hearing about in the not-too-distant future.” However, no plan has been released by Trump to date.

Given that the outcome of the presidential race could well determine the fate of the ACA, it is worth revisiting how the law’s major provisions improve health care coverage and affordability for millions of Americans, including you and me.

Specifically, the ACA:

Provides a safety net for those who do not have job-based health insurance coverage or government insurance, such as Medicare or Medicaid. Households with incomes from 100% to 400% of the federal poverty level receive subsidies that reduce the cost of their health insurance premiums. These federal subsidies could be on the chopping block next year, depending on the election results. Approximately 96% of enrollees in North Carolina received a premium tax credit to help them pay their premium.

Protects those with pre-existing conditions such as cancer, asthma, or diabetes from being denied coverage or charged higher premiums. This is one of the more popular provisions of the ACA. The number of Americans with a pre-existing condition varies depending on the definition used, with estimates ranging from 50 million to 129 million.

Allows young people to remain on their parents’ health plan until the age of 26.

Requires private health insurance plans to cover recommended preventive services without any patient cost sharing. These services include routine immunizations, evidence-based screenings and counseling, and preventive services for women.

Gives states the option of expanding their Medicaid programs. Enrollment in North Carolina’s Medicaid program has soared to more than 500,000 since the program began late last year, much faster than initial projections. Medicaid beneficiaries are now able to get the care they deserve at low cost.

Under President Biden and Vice President Harris, coverage under the ACA has become more affordable and accessible. For example, the Centers for Medicare & Medicaid Services reports that Americans with ACA marketplace coverage save an average of $800 per year under the Inflation Reduction Act, which was approved by Congress in 2022 with no Republican support.

Elections matter. Health care accessibility and affordability matter. Please join me in securing the future of the ACA and its many benefits by voting for Kamala Harris for President.

Laura Allendorf, Manteo

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