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What is Affordable Care Act?

The Patient Protection and Affordable Care Act, commonly known as the Affordable Care Act (ACA), was signed into law by President Barak Obama on March 23, 2010. The ACA was created in an effort to improve healthcare by making premiums more affordable, eliminating discrimination based on gender or health, and expanding coverage so that most Americans have health coverage.

Affordable Care Act Provisions

The ACA establishes several basic provisions regarding both free market and government health care. These include the removal of annual and lifetime dollar limits for essential benefits, limiting the removal of patrons from healthcare plans to fraud, better rates and coverage for those with pre-existing conditions and free preventative services. It also regulates how much insurance companies can spend on non-medical costs and prevents them from charging individuals or groups more based on health status, gender, or salary.

Benefits Under the ACA

Several benefits to consumers were introduced by the Affordable Care Act.

  • Children can now remain on their parents’ healthcare plan until age 26.
  • Insurance companies must use standardized documents to describe plan options, making comparison shopping between different companies much easier.
  • Insurance companies can’t charge more for women or for people with pre-existing conditions.
  • Individuals can only be dropped from their insurance plan if the insurance company proves fraud. Honest mistakes on a form or developing a serious illness are no longer reasons for denying coverage.
  • Health care plans must offer preventative care with no out-of-pocket cost.
  • As of 2014, insurance companies are no longer allowed to place caps on what they will pay for essential services, either per year or over an individual’s lifetime.
  • Every health plan must offer ten essential benefits, including hospitalization, emergency services, maternity and pediatric care, prescription medication, lab services, rehabilitative services, pediatric dental and vision care, outpatient services, preventative care, and mental health and substance abuse treatment.

Issues with the Affordable Care Act

As with any piece of major legislation, issues have arisen as deadlines for changes to the health care system are approached. The elderly, poor, and chronically ill benefit greatly from ACA mandates. However, someone has to bear the cost. The financial support of those who receive free or low-cost healthcare rests mainly upon young people and the wealthy. Some of the costs are also spread among the insurance companies and healthcare providers.

Another issue that doesn’t sit well with everyone is that purchasing healthcare is no longer an option. The individual mandate put forth by the Affordable Care Act means that those who don’t receive an exemption must either purchase an insurance plan or pay a hefty fine for each full month they are uninsured.

Those who aren’t eligible for government programs like Medicaid and Medicare and don’t have a health plan available through their employer have a limited window of opportunity to enroll each year. If insurance buyers fail to make a purchase before the open enrollment period expires, they must wait for the next open enrollment event to sign up for a plan. However, exceptions may be available immediately following major life events such as a marriage, birth, or change in employment.

Affordable Care Act and Businesses

Employers with 50 or more employees must provide health care as a benefit for their workers. While larger companies regularly include health benefits, small businesses who intend to scale in the next few years should include ACA mandates as part of their overall strategy. Companies with 25 or more employees are encouraged to offer health insurance via incentives like tax breaks and credits.

The benefits that the Affordable Care Act offer you depend upon your specific circumstances. Get affordable answers from verified Experts from the convenience of home, any time.

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