Introduction to Obamacare

This type of health insurance, often referred to as ACA, PPACA, or “Obamacare” is the landmark health reform legislation passed by the 111th Congress and signed into law by President Barack Obama in March 2010.

What does health care reform encompass?

The law has many goals for the uninsured.  In a nutshell, the goals of ACA are the following:

• To make health insurance more affordable. For example, by expanding cost assistance based on income to lower health insurance premiums and out-of-pocket costs and by expanding Medicaid to all adults based on income.
• Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level. (Not all states have expanded their Medicaid programs.)
• Support innovative medical care delivery methods designed to lower the costs of health care generally through private insurance companies.
• To expand patient protections. For example, by stopping insurers from charging more for pre-existing conditions and setting dollar limits on care.
• To curb healthcare costs. For example, via regulations and taxes on those who benefit the most from healthcare reform like insurers and drug companies.
• To improve the quality of health insurance and healthcare. For example, by requiring essential benefits on all plans and rewarding hospitals for quality over quantity.  The law requires "essential health benefits" including:
  • Ambulatory patient services
  • Breastfeeding
  • Emergency services
  • Family planning
  • Hospitalization
  • Laboratory services
  • Mental health and substance use disorder services
  • Pregnancy, maternity, and newborn care
  • Prescription medications
  • Preventive and wellness services and chronic disease management
  • Pediatric services
  • Rehabilitative and habilitative services

In addition, the AffordableCare Act requires most insurance plans (including those sold on the Marketplace) to cover at no cost to policyholders preventive services. These include checkups, patient counseling, immunizations, and numerous health screenings.  Most notably, the healthcare reform protects individuals and families from being denied health insurance for pre-existing conditions, dependent children can remain on their parents’ plan until age 26 and annual dollar limits on out-of-pockets expenses for healthcare.

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