‘A big safety net’: Affordable Care Act filled need, fended off dismantling in 2020

4 min readNov 28, 2020

Between February and June, an estimated 14.6 million people lost their employee-sponsored health insurance. Elements of Obamacare helped shore up those losses.

A demonstrator holds a sign in front of the Supreme Court in support of the Affordable Care Act in Washington on Nov. 10, 2020.Nicholas Kamm / AFP — Getty Images

Nov. 28, 2020, 3:29 PM +06

By Phil McCausland

This year, Americans’ access to health care took the spotlight like never before.

Since March, more than 250,000 people and millions more have lost their health insurance in the

During the presidential campaign, both President Donald Trump and President-elect Joe Biden promised much to address these health and economic issues, sparring on how best to provide Americans access to health care. Central to both of their arguments remained a decade-old law: the Affordable Care Act — landmark health care legislation that showed its continued significance during this particularly difficult year.

Trump wanted to dismantle it, while consistently promising a replacement plan that never materialized, and Biden promised to build on the current law with hopes of offering a public option.

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“Healthcare is the kitchen table issue for most Americans, both because of cost, and because of what it means to go through life without coverage,” said Leslie Dach, a former senior counselor at the Department of Health and Human Services during the Obama administration.

“We are now at a time this year when people needed the ACA more than ever, and years of studies have shown how its coverage has positive impact on people’s health, life expectancy and the ability to get a job,” added Dach, the founder of Protect Our Care, a liberal group aimed at protecting the law. “And yet for purely partisan or ideological reasons, people are trying to take it apart.”

Those efforts haven’t been particularly fruitful.

‘A big safety net during the pandemic’

A little more than 10 years after the law known as Obamacare was passed, the landmark health care legislation has survived numerous attacks under the Trump administration and appears to be deeply embedded in the nation’s health care system. The effect it has had during this difficult year — whether in politics, policy or at the kitchen table — is hard to dispute.

Though it is currently difficult to know exactly how many people remain without their health insurance because of the current economic crisis, between February and June approximately 14.6 million people — workers and their dependents — were affected by job losses that also resulted in losing employee-sponsored health insurance, an estimate by the Commonwealth Fund concluded.

In states that passed Medicaid expansion, the Affordable Care Act helped shore up some of those losses, particularly as rolls for the public health insurance option for low-income people have ballooned this year.

Other people have found options through the plans offered by the ACA or received coverage from a spouse or parent, COBRA, short-term health plans or just gone without.

The exact number of people who lost insurance in 2020 will remain unknown until late next year. The Congressional Budget Office released a report in September looking at the amount of people who were uninsured in 2019–30 million — and they estimated that the number could jump by 1 million people because of the pandemic.

‘A big safety net’: Affordable Care Act filled need, fended off dismantling in 2020

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