The Affordable Care Act (ACA)

The Affordable Care Act (ACA), often referred to as Obamacare, is an act created to offer all Americans health insurance coverage that is both affordable and comprehensive. The ACA was signed into law in 2010, under the Obama Administration, and offers protection against increased health care costs and restricted medical care. The ACA is especially important for individuals who have a disability or a pre-existing medical condition, including a chronic pain diagnosis; the law prevents the denial of coverage or an increase in rates due to an individual’s medical history. Increased taxes on medical devices, pharmaceutical sales and higher incomes were initiated to help pay for the ACA. The U.S. Congress, legislation proposals, presidential administrations and health care lobbyists are likely to initiate changes to the ACA yearly.

Before the Affordable Care Act became federal law, insurance companies had a ceiling on the dollar amount that would be paid per an individual’s lifetime, resulting in the cessation of coverage when this amount was met. The ACA now governs that insurance companies can no longer have a lifetime monetary ceiling on provided coverage, and 80 percent of premiums obtained by insurance companies must be used on medical care and advancements. The ACA is attempting to make prescription drugs affordable; however, many people may experience a higher health insurance premium to make this possible. Fines for individuals who do not have health insurance were eliminated in 2019.

What does the Affordable Care Act cover?

• Physician visits
• Emergency services
• Preventative health screenings and services
• Hospital stays
• Maternity care
• Newborn care
• Prescription drugs
• Other services deemed necessary

How do individuals obtain coverage through the ACA?

Although the process of obtaining insurance under the Affordable Care Act varies in each state, all U.S. citizens have access to the ACA Marketplace (or Exchange) that lists available healthcare plans in their location. Individuals can compare benefits and premiums of each health insurance company listed. Financial aid, provided by way of tax credits, may be available for certain individuals to assist with premium costs, and cost-sharing subsidies may help with deductibles and/or co-pays. Financial aid depends on yearly income, number of people in the household and geographic location. The ACA Marketplace not only helps individuals and families obtain insurance, it also helps them determine the best insurance policy to fit their needs. The ACA also guarantees that children are covered under their parents’ policy until the age of 26.

To learn more or apply for coverage, visit healthcare.gov.