The Affordable Care Act (ACA) was passed in 2010, in the second year of President Obama’s first term. The Republicans immediately took to calling it Obamacare and have been trying to repeal it as unconstitutional ever since it was passed. A Republican court case even made it to the U.S. Supreme Court, which upheld the constitutionality of the ACA by a five to four vote. Republicans continue to challenge the ACA, so expect it to continue to be in the news. The ACA has three main goals:
- Reduce the price of health insurance in order to make it available to the millions of people. The government subsidizes the cost of health insurance for households whose incomes are 100% to 400% of the federal poverty level.
- Expand Medicaid. Medicaid is free health insurance for households whose incomes are substantially below the federal poverty level. States are responsible for administering Medicaid, and many states with Republican governors or legislatures refused to accept this expanded federal aid.
- Find and support medical care delivery systems that lower the cost of providing healthcare.
The ACA has been successful by any measure. In 2020, 23 million people are covered by the ACA. In addition, 31 states accepted the expanded Medicaid program. In 2020, a total of 73 million people are now insured under Medicaid or under the Children’s Health Insurance Program (CHIP). In addition, children are now able to remain on their parents’ healthcare policy until they turn 26, and no insurance company can refuse healthcare coverage because of a pre-existing condition.
Another benefit of the ACA is that it modernized the health insurance search, establishing an online marketplace for health insurance. When you access the marketplace, you will be asked some relevant questions and receive an estimate of the subsidy you may qualify for. After this, you will have access to the private insurance companies offered through the marketplace. All participating companies must offer at least these ten essential benefits in their plans:
- Ambulatory patient services (outpatient care)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy, maternity, and newborn care(both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (but adult dental and vision coverage are not essential health benefits)
In addition to these, birth control coverage and breastfeeding coverage must also be offered.
Finally, health insurance plans on the marketplace can offer additional coverage for services like dental and vision care, but these plans will cost you more. As I said before, if you lose your healthcare coverage due to any reason, you should at least buy a minimum policy that will cover an unexpected illness. Look at the ACA Marketplace for these options.