The Affordable Care Act (ACA) was signed into law by the Obama Administration in 2010 to help more Americans access health insurance. This healthcare reform law has three main goals:
- Make health insurance more affordable and available.
- Expand Medicaid by raising the income limit.
- Support medical care delivery methods that lower healthcare costs.
Before the ACA, healthcare providers could discriminate against applicants or charge higher monthly dues based on medical conditions these applicants already had. The ACA eliminated waiting periods that allowed providers to wait before covering pre-existing medical conditions. This, along with premium and cost-sharing supports, the ACA has reduced costs and care for eligible individuals.
ACA Marketplace
The ACA introduced the Marketplace, where people can shop for health insurance plans that fit their needs and budgets. In the Marketplace, individuals can compare the costs and benefits of these ACA-compliant plans and, from November 1 to January 15, in what is known as Open Enrollment, can sign up or change their insurance plans.
Since its introduction, the Marketplace has helped fill the coverage options gap for those without insurance from work or public programs.
The 10 Essential Health Benefits
The ACA has also improved plan benefits by making sure all health insurance plans cover at least ten basic services, known as the 10 essential health benefits, which include:
- Ambulance transportation
- Emergency services
- Hospitalization
- Pregnancy, maternity, and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative services, including devices for injuries, disabilities or chronic conditions
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
All ACA-compliant health insurance plans must cover these benefits, including those in the Marketplace and individual and small-group markets off-exchange. They can also offer extra benefits like vision, dental, and medical management programs, like weight loss, though be mindful that enrollees may face out-of-pocket fees. Be sure to look into regional adjustments, as each state has rules about what is covered, making coverage specifics vary depending on where you live.
