Since its inception in 2010, the Affordable Care Act (ACA), also known as Obamacare, has reshaped the American healthcare landscape. Its comprehensive reform to health insurance laws sought to make healthcare more accessible and affordable for millions. Despite the controversy surrounding it, there’s no denying its impact on average Americans. Let’s unravel the basics of the ACA and see what it means for you.

The Aim of the Affordable Care Act

The primary goal of the ACA was to reduce the number of uninsured Americans and decrease healthcare costs. It aimed to achieve this by implementing mechanisms like mandates, subsidies, and insurance exchanges. It also introduced rules for insurance companies, preventing them from denying coverage due to pre-existing conditions or charging more based on gender or health status.

Individual Mandate and Penalties

One of the cornerstones of the ACA was the Individual Mandate, which required most Americans to have health insurance or pay a penalty. However, this penalty, termed the “individual shared responsibility payment,” was effectively reduced to zero in 2019 at the federal level, though some states have implemented their own penalties.

Pre-existing Conditions

Under the ACA, health insurers cannot refuse coverage or charge higher premiums to individuals with pre-existing conditions. This key provision ensures that millions of Americans with health issues can access and afford necessary healthcare.

Expansion of Medicaid

One of the ways the ACA aimed to reduce the number of uninsured was by expanding Medicaid. However, not all states chose to adopt this expansion. In states that did expand Medicaid, eligibility was extended to nearly all low-income individuals with incomes at or below 138% of the federal poverty level.

Insurance Exchanges and Premium Subsidies

The ACA established Health Insurance Marketplaces (also known as Exchanges) where individuals, families, and small businesses can shop for health insurance. To make these plans more affordable, the ACA introduced subsidies for individuals and families earning between 100% and 400% of the federal poverty level.

Young Adult Coverage

Under the ACA, children are allowed to stay on their parents’ health insurance plan until they turn 26. This provision has significantly increased the number of insured young adults.

Essential Health Benefits

The ACA requires all insurance plans to cover ten “essential health benefits,” which include services like emergency services, hospitalization, maternity and newborn care, prescription drugs, and preventive and wellness services.

The Affordable Care Act has changed the healthcare conversation in the United States. While it’s not without its challenges and criticisms, its provisions have impacted millions of Americans’ access to health coverage. Whether it’s the protections for individuals with pre-existing conditions, expanded Medicaid coverage, or the introduction of health insurance exchanges, the ACA continues to shape our healthcare system’s landscape.