The Affordable Care Act (ACA) – Major Health Insurance Reforms

affordable care act

The Affordable Care Act (ACA) includes major reforms to health insurance in the United States. The law expands coverage options for individuals and families, helps people with lower incomes afford coverage, and strengthens Medicare. The ACA also creates a health insurance marketplace where consumers can compare and shop for private insurance plans, and requires insurers to provide maternity, mental health, and preventive care as part of every plan. It also prohibits insurance companies from denying, canceling or charging more for policies because of preexisting conditions.

The ACA provides new federal funding for state Medicaid programs to cover preventive services at no cost to enrollees. It also expands the number of Americans who can deduct health insurance costs from their taxes by raising the threshold to 7.5% for people age 65 and older, and to 10% for seniors enrolled in Medicare Advantage and Prescription Drug Plans. It also ensures that women can continue to see their preferred OB/GYN even when their insurance changes providers, and eliminates lifetime limits on health benefits.

In the marketplace, people with preexisting medical conditions can receive help paying their premiums and out-of-pocket costs through tax credits available to those with the lowest incomes. The ACA also establishes a reinsurance program to help pay for the highest-cost enrollees.

It ensures that people who have continuous health insurance coverage will not be left uninsured by requiring insurers to renew policies for current enrollees and allowing young adults to stay on their parents’ insurance until they are 26 years old, as long as they do not work full-time or are married. It also prohibits insurers from putting annual or lifetime caps on the amount they will pay for an individual’s care, and restricts how much of a profit they can make.

The ACA includes measures to promote culturally competent healthcare and expands initiatives to assist health centers in providing this care. It aims to improve health outcomes and reduce disparities among lesbian, gay, bisexual, transgender, intersex, asexual, and gender minority populations, as well as bolstering efforts to support HIV prevention and treatment.

In a major victory for the ACA, the Supreme Court rebuffed the most recent challenge to its constitutionality, which would have struck down the minimum coverage requirement. It also reaffirmed that a penalty for going without health insurance is a legitimate use of Congress’s taxing powers.