The Affordable Care Act (ACA) was a landmark health reform law passed in 2010 that changed many aspects of the American health-care system. The ACA has faced both support and opposition, and has undergone several changes through legislation and legal challenges. The goal of the ACA was to achieve near-universal health insurance coverage through the promotion of individual responsibility and market-based solutions. It includes a number of provisions that regulate private health insurers and make insurance more affordable for low-income Americans by increasing the amount of financial assistance available through the exchanges and reducing costs for people with preexisting conditions. It also requires health plans to cover preventive services without charging patients out-of-pocket, and prohibits annual and lifetime limits on the dollar amount of coverage.
One of the most significant aspects of the ACA is the expansion of Medicaid to people who had been denied coverage due to preexisting conditions. The ACA also provides subsidies to help people buy individual health insurance. These are based on a percentage of the cost of premiums, and are available for people with incomes between 100% and 400% of the poverty line.
The ACA also requires that all health insurance coverage include essential benefits that are not limited to certain categories of services, such as emergency services and prescription drugs. These must be included in all health plans offered through the exchanges and off-exchange, except for short-term plans. The ACA also includes rules about the ability of individual and small group insurance markets to adjust their rates annually, as well as restrictions on advertising of medically unnecessary procedures.
Another aspect of the ACA is its requirement that health-insurance providers provide consumers with an easy way to find out if their plan does not meet minimum benefit requirements. It also imposes regulations on health-insurance issuers regarding patient privacy and the handling of complaints. It also requires that health-insurance issuers give their consumers rebates on the costs of certain preventive care, such as immunizations and cancer screenings.
Finally, the ACA requires health-insurance issuers to establish a process for appeals of coverage decisions and claims. It also mandates that health-insurance issuers disclose to individuals how much they pay for their coverage on average. The ACA also requires that most health-insurance issuers establish programs to assist their customers with accessing public benefits, such as Medicaid and the Children’s Health Insurance Program.
The ACA also contains a number of other provisions that do not directly relate to health-insurance coverage, such as requiring the Food and Drug Administration to approve generic versions of biologic drugs, and improving data collection and reporting on disparities in access to healthcare. It also includes provisions to reduce waste and fraud, and encourages research on the effectiveness of different treatment options for chronic illnesses. It also authorizes grants to improve state health-insurance exchanges. It also creates a new system of electronic health-care transactions and sets forth requirements for their use. Finally, it requires the Secretary of Health and Human Services to award grants to states to establish offices of health insurance consumer assistance or ombudsman programs.