The affordable care act is a law that changes how you and your family get healthcare. It includes a range of reforms to health insurance markets and to how you pay for it. It also contains important tax provisions that impact individuals, families, businesses and tax-exempt organizations.
The ACA makes it illegal for insurance companies to deny you coverage or charge you higher rates because of a pre-existing condition. It also requires all plans to offer certain core benefits, including prescription drug coverage and hospitalization coverage. And it limits how much insurers can vary your premium based on where you live, your age, tobacco use and other factors.
These and other ACA policies are credited with helping drive the uninsured rate down to historic lows and helping millions of Americans get access to quality, affordable healthcare. However, rising healthcare costs and uncertainty over future policy changes remain major challenges for the country.
Since the ACA passed in 2010, public opinion of the law has been mixed and has shifted with each change in presidential administration. Some provisions, such as the individual mandate and a penalty for non-compliance, were never popular, while others, such as protections for preexisting conditions, have been broadly supported.
In recent years, the ACA has been subject to a series of legal challenges and political debates that have created uncertainty over its future. A number of key provisions are still under threat, and shifts in political control could have significant impacts on the availability of subsidized marketplace plans, the continued operation of ACA marketplaces and other essential health benefits and consumer protections.
The ACA’s expanded marketplaces provide marketplace subsidies to help people afford health coverage. These marketplaces allow consumers to shop for private insurance and choose from a variety of options that meet the ACA’s minimum requirements. ACA marketplace plans must cover 10 essential health benefits, which include coverage for hospitalization and surgery, as well as chronic disease management services like diabetes and blood pressure control. These plans can be purchased on the ACA marketplace or in private health insurance markets outside of the exchanges. The ACA allows for the sale of short-term limited duration insurance plans, which are not required to comply with ACA marketplace regulations and do not include coverage for essential health benefits.
The ACA also sets limits on how much more health insurers can increase their premiums each year, and requires them to publicly justify the reasons for any significant increases. In addition, the ACA prohibits insurers from charging older adults more than three times as much as they do younger adults. As a result, the ACA has helped to make private health coverage more affordable for many middle-class Americans, and is particularly attractive to young, healthy individuals. This has made the ACA one of the most popular sources of health coverage in America.