Ohio Republican Sen. Bernie Moreno speaks with reporters at the U.S. Capitol convoluted in Washington, Tuesday, June 3, 2025. (Photo by Jennifer Shutt/States Newsroom).
As efforts to expand health insurance subsidies stalled, one negotiator, Republican U.S. Senator Bernie Moreno, appeared to blame former President Barack Obama’s signature health care law, the Affordable Care Act.
“You have to remember that Democrats created Obamacare,” NPR reported in slow January. “It was abject failure in reducing costs.”
Is this really the case?
Republicans in Congress allowed subsidies for more than 400,000 Ohioans purchasing insurance under the Affordable Care Act to expire at the end of last year.
Costs for the average person have more than doubled due to the loss of subsidies. It is estimated that in their wake 113,000 Ohioans have already lost coverage entirely.
Nationwide, approximately 42 million Americans benefited from the subsidies after they expired.
Over 1 million have already lost coverage, as KFF reported earlier this month, and 4.8 million they are expected to stop being insured by the end of the year, the Urban Institute reported in September.
Moreno and other Republicans in Congress allowed those subsidies to expire months after renewing President Donald Trump’s 2017 tax cuts that largely favor the wealthiest Americans.
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Extending the subsidy will cost money approximately $350 billion over the next 10 years, while tax cuts will ensure: A $1 trillion windfall in the same period only to the richest 1%.
ACA subsidies benefited mainly lower-income Americans, including: 70% of recipients earning less than 250% of the federal poverty guidelines.
For an individual, it is less than $40,000 per year.
Trump’s spending bill also had a huge impact on programs for the poorest Americans.
This cut Medicaid spending by almost $1 trillion over 10 years and cut $186 billion from the federal food assistance program that many states already do a miserable job of serving entitled people.
Bilateral talks on restoring subsidies stalled slow last month.
Moreno accused Democrats of not wanting a solutionbut this is a problem to run.
For their part, Democrats accused Republicans of intervening poisonous pill in the form of anti-abortion regulations regulating health savings accounts.
Against this backdrop, Moreno said the Affordable Care Act has failed to deliver on its promises to save money.
When they heard this claim, several critics were quick to point out that in 2009, Republicans opposed “public option” — a measure included in the original ACA that supporters said was one of the most effective ways to lower health care costs.
It would be a government-sponsored plan offered on insurance exchanges that would compete with private plans and exploit the government’s purchasing power to lower the prices charged by providers.
There is also significant evidence that while the ACA does not nominally make health care cheaper, it has resulted in slower price increases.
This fact checking points to A 2020 study by the Journal of the American Medical Association stating that out-of-pocket health care spending has increased an average of 3.4% per year in the decade preceding the ACA.
Fact checks show that the rate dropped to 1.9% per year in the nine years after it went into effect.
Ezekiel Emanuel, oncologist and co-director of the Institute for Health Care Transformation at the University of Pennsylvania wrote the 2023 report opinion column in Stat News presenting his opinion on the reasons for the slowdown in medical inflation following the passage of the ACA.
The law created incentives for doctors to control costs, he said.
“The mindset of American doctors and other clinicians has changed, from ignoring costs to trying to cut them,” Emanuel wrote.
“Instead of coming up with more steep tests and treatments, doctors now ask whether the test or treatment will improve a patient’s health and how services can be delivered more effectively by changing where and how they are delivered.“
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Moreno’s office was asked whether he agreed that the ACA slowed the rate of medical inflation.
“The facts don’t lie: The Affordable Care Act was never there,” Communications Director Reagan McCarthy said in an email.
“Premiums and deductibles for individuals and families have skyrocketed while Democrat-signed legislation bailed out insurance companies at taxpayer expense. It’s a shame that Chuck Schumer rejected a good-faith, bipartisan effort to lower health care costs.”
McCarthy did not point to any evidence that medical inflation accelerated as a result of the ACA.
In terms of per capita running costs, they increased from $1,299 in 2010 to $1,514 in 2023 when amounts are expressed in 2023 dollars, – KFF reported.
This is an enhance of approximately 17%.
During a similar pre-ACA period, they increased from $979 in 1997 to $1,314 in 2009, an enhance of 34%.
If you look at total national health care spending on a 2023 per capita dollar basis, it increased by about 57% from 1997 to 2010 and about 29% from 2010 to 2023.
McCarthy did not directly answer a question about whether increasing the number of millions of uninsured people would come at a cost to all Americans.
With the passage of the ACA, the number of uninsured Americans increased decreased from 17.8% in 2010 to 9.5% in 2023.– KFF reported.
In 2009, approximately 46.5 million Americans were uninsured. By 2023, the number of uninsured Americans dropped to 25.3 million, the lowest level on record.
Several experts predict that the expiration of ACA subsidies and the Trump spending bill will result in millions of people being uninsured and that the uninsured rate will return to levels seen in the early years of the ACA.
One of the direct costs resulting from the high percentage of uninsured Americans is “unpaid care” — bills that everyone has to foot when people are unable to pay themselves.
Last year, the Congressional Budget Office projected that the spending bill alone would add 11 million Americans and 440,000 Ohioans to the uninsured population by 2034.
Last year, the Center for American Progress conducted an analysis showing it would enhance uncompensated care costs by nearly $1 billion in Ohio this year and $36 billion nationwide.
Emergency departments feel a particular burden of free care because they cannot turn away patients based on their ability to pay.
Last year, emergency room doctors in Ohio warned that there would be an enhance in uncompensated care enhance wait times for all patients and push some already stressed rural hospitals out of business.
