What is the Patient Protection and Affordable Care Act?
The Patient Protection and Affordable Care Act, commonly known as the Affordable Care Act (ACA), is a law that puts in place comprehensive health insurance reforms that will be implemented in stages over a multi-year period. The purpose of the law is to provide quality, affordable health care for all Americans. It will allow individuals, families, and small businesses to choose insurance coverage in an open, competitive insurance market. The Act also requires insurance companies to provide more coverage, reduce costs, and provide healthcare to those individuals previously disqualified.
How does the Affordable Care Act impact me?
- Ends Pre-Existing Condition Exclusions for Children: Health plans can no longer limit or deny benefits to children under 19 due to a pre-existing condition.
- Keeps Young Adults Covered: If you are under 26, you may be eligible to be covered under your parent’s health plan.
- Ends Arbitrary Withdrawals of Insurance Coverage: Insurers can no longer cancel your coverage just because you made an honest mistake.
- Guarantees Your Right to Appeal: You now have the right to ask that your plan reconsider its denial of payment.
- Ends Lifetime Limits on Coverage: Most benefits are banned from having a lifetime limit on coverage for all new health insurance plans.
- Reviews Premium Increases: Insurance companies must now publicly justify any unreasonable rate hikes.
- Helps You Get the Most from Your Premium Dollars: Your premium dollars must be spent primarily on health care – not administrative costs.
- Covers Preventive Care at No Cost to You: You may be eligible for recommended preventive health services without a copayment.
- Protects Your Choice of Doctors: Choose the primary care doctor you want from your plan’s network.
- Removes Insurance Company Barriers to Emergency Services: You can seek emergency care at a hospital outside of your health plan’s network.
Key Features by Year
2010: A new Patient's Bill of Rights goes into effect. Cost-free preventative services begin for many Americans.
2011: People with Medicare can get key preventive services for free and receive a 50% discount on brand name drugs that fall in the Medicare Part D coverage gap (Donut Hole).
2013: Open enrollment in the Health Insurance Marketplace begins on October 1st.
2014: Insurance plans are prohibited from discriminating due to pre-existing conditions or gender, annual limits on insurance coverage are eliminated , tax credits for middle and lower income people go into effect, Medicaid will be available to a larger population.
2015: Physicians will be paid based on quality of care rather than the number of patients that are treated.