The ACA, a federal act also referred to as health care reform and Obamacare, was put into effect on March 23, 2010. Its aim is to provide greater insurance coverage, enhance consumer safeguards, prioritize prevention and wellness, enhance healthcare quality and performance, broaden the healthcare workforce, and address the escalating costs of healthcare. The following are notable provisions of this fresh legislation:
- Insurance Exchanges – Each state is required to establish a health insurance exchange. Individuals and small employers (companies with 50 employees or less) may purchase insurance on the exchange (also called the health insurance marketplace). Open enrollment for 2014 begins October 1, 2013.
- Young adult coverage – You can now keep your adult children on your plan up to age 26.
- Pre-existing conditions – Starting in 2014, “pre-existing condition” limits go away.
- Preventive care services – Scheduled preventive services will be included in most individual policies and group benefit plans at no cost to members. This includes preventive and wellness services as well as prescription drugs. A full list of preventive care services covered by the Affordable Care Act can be found here.
- Guaranteed coverage – Beginning in 2014 you will be able to get insurance coverage without being turned down due to age, gender, health history, or where you live.
- Unlimited coverage – No lifetime or annual dollar limits on your health benefits.
- Same benefits for mental health – Mental health and substance abuse claims will be covered at the same benefit level as medical claims.
- Flexible Spending Accounts (FSAs) – These may no longer be used to pay for over the counter medications unless prescribed by a doctor. The annual maximum amount is $2,500.
- Subsidies – An estimated 26 million Americans will be eligible for subsidies from the government to help pay the premiums for health insurance coverage.
For even more information, the Kaiser Family Foundation has an entire section dedicated to the new law.
Frequently Asked Questions
What is the main purpose of the ACA?
The ACA, also known as Obamacare, aims to provide greater insurance coverage, enhance consumer safeguards, prioritize prevention and wellness, enhance healthcare quality and performance, broaden the healthcare workforce, and address the escalating costs of healthcare.
Who can purchase insurance on the health insurance exchange?
Individuals and small employers (companies with 50 employees or less) may purchase insurance on the health insurance exchange or marketplace.
Are there any provisions for pre-existing conditions in the ACA?
Yes, starting in 2014, the limits on “pre-existing conditions” were removed, which means you cannot be turned down for insurance coverage due to age, gender, health history, or where you live.
What kind of services are included in preventive care services?
Preventive care services include preventive and wellness services as well as prescription drugs. A full list of preventive care services covered by the ACA can be found here.
Are there any financial aids available for paying the premiums for health insurance coverage?
Yes, an estimated 26 million Americans will be eligible for subsidies from the government to help pay the premiums for health insurance coverage.
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