Affordable Care Act (ACA)


Affordable Care Act (ACA)

The Affordable Care Act (ACA), also known as Obamacare, is a health care reform law enacted in March 2010. The ACA’s main goal is to increase health insurance coverage and make it more affordable. Moreover, the ACA aims to expand Medicaid eligibility and support innovative medical care delivery methods to lower healthcare costs.

How the ACA Works

The ACA has three primary goals. First, it aims to make health insurance available to more people through subsidies, also known as premium tax credits. These subsidies help lower costs for households with incomes between 100% and 400% of the federal poverty level (FPL). Second, the ACA seeks to expand the Medicaid program to cover all adults with income below 138% of the FPL. However, not all states have expanded their Medicaid programs. Lastly, the ACA supports innovative medical care delivery methods designed to lower the costs of healthcare generally.

Health Insurance Marketplace

Under the ACA, patients who may have been uninsured due to preexisting conditions or limited finances can secure affordable health plans through the Health Insurance Marketplace in their state. The Health Insurance Marketplace is a platform where individuals, families, and small businesses can compare and purchase private health insurance plans.

Key Provisions of the ACA

The ACA’s major provisions came into force in 2014. Some of the key provisions of the ACA include:

  • Medicaid Expansion: The ACA revised and expanded Medicaid eligibility starting in 2014. The federal government provided financial incentives to states to expand Medicaid coverage to all adults with incomes up to 138% of the federal poverty level.
  • Health Insurance Exchanges: The ACA mandated that health insurance exchanges be provided for each state.
  • Individual Mandate: The ACA originally included an individual mandate, which required most individuals to have health insurance or pay a penalty. However, the penalty was eliminated in 2019.
  • Employer Mandate: The ACA includes an employer mandate, which requires employers with 50 or more full-time employees to offer affordable health insurance to their employees or pay a penalty.
  • Essential Health Benefits: The ACA requires all new health insurance plans to cover a set of essential health benefits, such as preventive care, prescription drugs, and mental health services.

Impact of the ACA

The ACA has had a significant impact on the US healthcare system. By 2016, the uninsured share of the population had roughly halved, with an estimated 20 to 24 million additional people covered. However, the ACA has also been the subject of political controversy and legal challenges.