The Affordable Care Act and Health Insurance in America

affordable care act

The affordable care act, formally known as the Patient Protection and Affordable Care Act and colloquially referred to as Obamacare, has had several transformative effects on health insurance in America. The ACA was designed to make healthcare more accessible and affordable for millions of Americans.

In order to help control rising healthcare costs, the ACA established Health Insurance Marketplaces where individuals could shop and compare health insurance options. This allowed individuals to find the right plan for their specific needs, and also offered a variety of subsidized plans for those with low or moderate incomes. Additionally, the ACA promoted transparency by requiring insurers to disclose how much of their premium revenue is spent on healthcare services versus administrative expenses or profits.

Another important aspect of the ACA is that it prohibits insurance companies from denying coverage or charging higher premiums based on pre-existing conditions. This ensures that those with pre-existing medical conditions are able to get quality coverage at an affordable rate. The ACA also prohibits lifetime and most annual dollar coverage limits, preventive service exclusions, and excessive waiting periods. Furthermore, the ACA promotes prevention through the use of Accountable Care Organizations, which are networks of healthcare providers that collaborate and share information in order to provide better care and improve outcomes for their patients.

The ACA also makes it easier to access and change health insurance plans by establishing an annual open enrollment period. This allows individuals to sign up or change their current insurance plan at any time throughout the year, and also makes it more convenient for those who travel or move often to maintain their health insurance. The ACA also encourages healthcare providers to work together by implementing new payment models such as Accountable Care Organizations, which foster collaboration and improved care for their patients.

Although the ACA has had a positive impact on the availability and affordability of health insurance, there are several issues that have arisen regarding its legality. The ACA has been challenged in multiple lawsuits, but the Department of Justice is vigorously defending the law.

The most significant issue is the fact that some people are not enrolled in a plan that meets their individual healthcare needs. Many people have found that their employer’s plan does not meet the ACA’s minimum coverage requirements, which are defined as an “actuarial value of 60 percent or more.” The Congressional Budget Office has estimated that the cost of an average non-subsidized individual monthly premium for an ACA marketplace bronze plan in 2021 was $450 per month. However, these costs can vary by state and individual health insurance needs. This is why we recommend working with a licensed and reputable health insurance broker to determine the best option for you.