The Affordable Care Act is a complex and comprehensive law that makes major changes to the health insurance marketplace. It includes requirements for individuals and employers to have coverage, creates state-based health benefit Exchanges where consumers can shop for coverage, and provides subsidies to assist those with the lowest incomes to help them afford their premiums and out of pocket costs.
The law also establishes consumer protections and promotes innovation to ensure that the American health system becomes more efficient and competitive. It expands consumer choice and transparency by allowing consumers to open new types of savings accounts, such as flexible spending accounts and health reimbursement arrangements, which can be used to pay for a portion of their health care costs not covered by insurance. It also allows Americans to buy low cost catastrophic coverage, which is an alternative to traditional health insurance plans and will be available through the individual market.
Since the ACA’s main coverage provisions took effect in 2014, we’ve seen a precipitous decline in the uninsured rate like no other time in our history. And while there’s still work to do, we’ve made progress — and the future looks even brighter.
A Health Care Bill of Rights for Patients
The ACA protects consumers from abusive practices by insurance companies, and the new consumer protections are helping make health care more accessible, affordable, and high-quality. These protections include:
End to Pre-Existing Condition Discrimination: Before the ACA, insurers could deny coverage to people with pre-existing conditions or charge them more for it. But that changed when the ACA went into effect in 2014. Now, people with pre-existing conditions can’t be denied coverage, or charged more for it. And insurers can no longer impose lifetime dollar limits on essential health benefits. In addition, insurers can no longer cancel coverage when you get sick just because of a mistake on your application.
Expanding Community Health Centers: The ACA continues to invest in the nation’s network of community health centers, which provide access to primary and preventive health services for millions of Americans every year. This includes initiatives to support cultural competency training and improve outreach for underserved populations, including efforts focused on addressing the needs of LGBT communities affected by HIV and viral hepatitis.
The ACA requires most U.S. citizens and legal residents to have health insurance or face a penalty. Individuals have the option to purchase insurance through the Exchanges or directly from private insurers. Those purchasing insurance through the Exchanges are required to choose a plan that meets certain minimum standards for quality and affordability.