Affordable care act

The affordable care act

• Passed in 2010

• Sometimes referred to as Obama care

The affordable care act provisions

• Required health insurance companies to offer better quality plans

• It required health insurance companies too cover a variety of things that in the past have been optional

• No limits on pre-existing conditions (for example they may not want a person on their plan because they’re going to be an expensive person to cover)

• Band annual and lifetime limits

10 essential benefits of the Affordable care act

Preventable/wellness coverage

• The ACA said that all plans have to cover Preventive and wellness services and they have to do so at zero cost to the patient

Medicaid expansion

When the law was written, federal government was going to require the states to expand Medicaid, and that the federal government would provide funding to the states to help cover the cost of that and they would in fact cover almost all of the cost of increasing access to Medicaid

• and for those who are 100% over the federal poverty line income, but did not get insurance through their employer so they had to purchase their own plan the government would have income subsidies to help people afford the cost of a private plan and anybody who made up to 400% of the federal property line would be eligible for subsidy but it did not go like this

Instead

• instead of every state, expanding Medicaid, the states were given a choice

  • and in some states, you still had people who were in the coverage gap so they were not eligible for Medicaid because they made too much but they did not make enough to get those marketplace subsidies so they didn’t get help buying their own plan and so most of those people remain uninsured

• But as of November 2020 most states have now expanded Medicaid access

Challenges that the ACA has met

Individual mandate

The ACA was originally written with a mandate that everyone has to have health insurance and that if you don’t have health insurance, you have to pay a tax penalty at the end of every year

Due to some court cases and legislative changes, there is essentially no more individual mandate so is there is no tax