The uninsured rate for U.S. adults fell sharply, from 17.1 percent a year ago to an average of 12.9 percent for the fourth quarter of 2014, with the rate declining among nearly all demographic groups. The Affordable Care Act has accomplished one of its goals to decrease the number of uninsured Americans. In addition, the impressive numbers indicate that the appetite for affordable health insurance was strong enough to get past the flawed rollout of the federal marketplace website.
Still, with the new 114^th Congress and impending Supreme Court case, the Affordable Care Act faces many challenges.  In an effort to undermine the health law’s employer mandate, the House voted (252-172) on Thursday to change the definition of full-time employment under the health law. The bill (H.R. 30) redefines the ACA’s current full-time work week from 30 hours to 40 hours a week. Since 44 percent of the workforce was employed 40 hours last year while only 7 percent worked between 30 to 34 hours, the new bill threatens to put far more workers at risk of having their hours cut. The Congressional Budget Office and Joint Committee on Taxation said that the bill will increase the deficit by $53 billion because it will reduce revenue by lowering the number of companies liable for penalties because they do not provide health insurance. It is not clear what the fate of the bill will be in the Senate; however, President Obama has warned if Congress passes the bill he will veto it.

The House also passed (412-0) on Tuesday a bill (H.R. 22) that would exclude veterans and other employees who have health coverage through the Department of Defense or Veterans Affairs from counting towards the number of employees a business has to have before its required to provide health coverage.  As of Jan. 1, employers with at least 100 full-time employees are required to provide health coverage or pay a penalty. That requirement is set to expand to employers with at least 50 full-time employees in 2016. The Congressional Budget Office and Joint Committee on Taxation have said this bill will increase budget deficits by $858 million over 11 years.

In addition to these legislative challenges, the health law faces an upcoming court battle. The Supreme Court is expected to take up a challenge to subsidies provided under the law. The case questions whether the Affordable Care Act’s subsidies are permitted in the 34 states that didn’t build state exchanges but instead use the federal exchange. The Supreme Court is likely to take up the case this March.

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