The Affordable Care Act (ACA) came into operation when President Barack Obama signed it into law in 2010. Also known as Obamacare, this act was a major overhaul of the healthcare system in the United States. The original purpose of the ACA plan was to lower healthcare costs for the average American.
Originally, the act required everyone in the country to have health insurance. More importantly, it offered cost assistance to individuals who could not afford a health insurance plan on their own.
What is Obamacare?
Contrary to what most people think, the Patient Protection and Affordable Care Act is not about health insurance only. It transformed the way the government delivers health care to its citizens. Interestingly, it was the President’s critics who first coined the term “Obamacare.” The term sort of stuck.
On March 30, 2010, the Health Care and Education Reconciliation Act amended Obamacare. The Affordable Care Act, therefore, refers to the amended version of the law. It provides many protections and rights that make health coverage easy to understand and more fair. It also provides for subsidies, through cost-sharing reductions and premium tax credits, to make it more affordable.
Protections and Rights
Some of the protections and rights permitted by the ACA apply to individual health insurance and the health insurance marketplace in general. Some apply to job-based health insurance plans, while others apply to all forms of health coverage. However, some of these protections may not apply to individuals with a grandfathered health insurance plan.
A grandfathered plan is any type of health policy purchased or created before the passage of Obamacare. You may have a grandfathered plan if you bought one directly from a broker, agent, or insurance company. Grandfathered plans fall into two main categories, which are:
- Individual grandfathered health insurance plans
- Job-based grandfathered health insurance plans
These policies do not have to provide some of the protections and rights the marketplace plans do. Some of the protections and rights they do not offer include:
- Cover for a pre-existing health condition
- Free preventative care
- An end to the limiting of lifetime or yearly coverage expenses for vital or essential health benefits
- Rights to appeal a decision on health coverage
- The right to choose your doctor or access to emergency care
The primary goal of this act was to slow down the increasing cost of health care. The idea was to take steps to make health insurance more affordable and available to people who need it most. The act also requires everyone to pay a certain tax penalty or have health insurance. Obamacare aimed to make health insurance more affordable and available to individuals with the lowest incomes by subsidizing health insurance costs.
Medicaid, for example, provides health coverage to millions of people in the United States. This includes people with disabilities, the elderly, pregnant women, children, and low-income individuals. The federal government extended it to those who earn up to 138 percent of the poverty level.
However, as of 2020, 14 states chose not to expand Medicaid. This limited health insurance accessibility for their residents. Fortunately, some ACA taxes are still in effect. Even though Congress limited some of its powers, you can still take advantage of the sections that still work. For example, under Obamacare, insurance policies must allow parents to include their kids on their plans up to 26 years of age. They must also offer 10 essential services, which are:
- Wellness and preventive visits
- Emergency room services
- Maternity and newborn care services
- Outpatient care
- Behavioral and mental health treatment
- Prescription drugs
- Devices and services to help patients with chronic conditions, disabilities, or injuries
- Pediatric care
- Lab tests
Although Congress made several changes to the ACA; it remains strongly in place. Most importantly, it gives you certain protections and rights, in addition to benefits such as breastfeeding support and equipment, the right to appeal a health plan decision, birth control counseling, and more.
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