By Laura Waddell
On March 23, the Affordable Care Act turns 16 years old. For millions of Americans, and hundreds of thousands of people here in New Jersey, that anniversary represents something worth celebrating: the right to affordable health coverage and basic consumer protections that were once out of reach.
Before the law passed in 2010, too many families lived one illness away from financial ruin. Insurance companies could deny coverage to people with pre-existing conditions, drop patients when they got sick, or charge unaffordable premiums simply because of their health history. The Affordable Care Act changed that reality.
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Since its passage, the law has driven the uninsured rate down to historic lows. It expanded access to Medicaid for millions of low-income workers and families and created marketplaces where individuals and small businesses can buy coverage with financial assistance. Here in New Jersey, more than half a million residents now rely on the state’s marketplace to obtain coverage.
But the work of making health care truly affordable and accessible for everyone is far from finished, and much of our progress is threatened. Instead of building on the last decade of progress, President Donald Trump and congressional Republicans, including New Jersey’s own Reps. Jeff Van Drew, Tom Kean Jr., and Chris Smith, voted to cut $900 billion in health care funding that stripped coverage for hundreds of thousands of New Jerseyans and increased premiums for all. Furthermore, the expiration of the ACA enhanced premium tax credits removed the critical benefit of keeping health insurance premiums manageable for working families.
We are already seeing the consequences.
Enrollment patterns in New Jersey’s 2026 GetCoveredNJ marketplace have shifted dramatically. Those populations with incomes under $16,000 for individuals and $33,000 for families of four have fallen by 37%. Silver plan enrollment decreased by 15%, while enrollment in Bronze plans surged by 31%. This shift matters. Bronze plans typically come with much higher deductibles, meaning families are paying more for coverage that they often can’t afford to use except in a medical emergency. In other words, people are being pushed into skimpier coverage because comprehensive plans are becoming too expensive.
And while working families face higher premiums and the threat of losing coverage, the nation’s largest health care insurers are thriving with record profits and billions in revenue. In 2024 alone, the CEOs of the nation’s six largest health insurers took home a combined $159.4 million in pay. Yet rather than holding these corporations accountable for price gouging, new federal tax breaks and loopholes are allowing them to keep more of their profits instead of lowering costs for everyone.
That contradiction is not always obvious to voters. Many of us hear claims from Washington that cuts to health programs are about reducing “waste and fraud,” while tax breaks are described as relief for working families. At the same time, politicians who attack the Affordable Care Act attempt to blame rising costs on the very premium tax credits that make coverage affordable.
The reality is much simpler: You cannot lower health care costs by cutting coverage while rewarding corporations that raise prices.
That’s why this year’s Affordable Care Act anniversary should not only be a moment of reflection, but also a moment of action. Medicaid cuts can be repealed and the enhanced premium tax credits can be reinstated — or perhaps even better options could be found — but only with bipartisan leadership. New Jersey’s federal delegation needs to work together to address our health care affordability crisis. When fewer people are insured, it raises costs for everyone. There is no time for delay; too many New Jerseyans face a fiscal cliff in coming months they may not come back from.
Sixteen years ago, the Affordable Care Act proved that progress is possible when people organize and demand change. Today, the mission is just as urgent: protect the gains we’ve made, hold policymakers accountable, and ensure that our health care system puts patients before profits because every family in New Jersey, and across the country, deserves health care they can afford and rely on.
Laura Waddell is the health care program director for New Jersey Citizen Action. In her role, Laura leads the organization’s health care policy and outreach work and convenes the NJ For Health Care coalition of over 70 state partner organizations dedicated to expanding access to quality, affordable health care to all New Jerseyans. In addition, she leads the NJ For Affordable Drugs campaign of almost 30 state partner organizations. She comes to New Jersey Citizen Action with a master’s of science degree in public administration from Rutgers University, a master’s of science degree in jurisprudence from Seton Hall University School of Law, and a bachelor’s of science degree in marketing from Lehigh University.
