Navigating the Health Insurance Landscape by Robert Adziashvili - HTML preview

Chapter 4

Overview: How Affordable Care Act (ACA) works and its implications

The Affo rdabl e Care Ac t , al so k n o wn as O bamac are, i s a l aw i n t he U n i t ed S t at es t hat hel ps mak e heal t hc are mo re ac c essi bl e an d affo rdabl e fo r man y peo pl e. It wo rk s by c reat i n g a mark et pl ac e where i n di v i dual s an d fami l i es c an c o mpare an d c ho o se fro m di fferen t heal t h i n suran c e pl an s. The ACA al so pro v i des fi n an c i al assi st an c e t o t ho se who qual i fy based o n t hei r i n c o me, mak i n g i t easi er fo r t hem t o affo rd c o v erage. Thi s mean s t hat mo re peo pl e c an hav e ac c ess t o essen t i al heal t hc are serv i c es, suc h as do c t o r v i si t s, prev en t i v e c are, presc ri pt i o n medi c at i o n s, an d mo re.

O n e i mpo rt an t feat ure o f t he Affo rdabl e Care Ac t i s t he pro t ec t i o n i t o ffers t o peo pl e wi t h pre-exi st i n g c o n di t i o n s. Befo re t he ACA, i n suran c e c o mpan i es c o ul d den y c o v erage o r c harge hi gher premi ums t o i n di v i dual s wi t h pre-exi st i n g c o n di t i o n s l i k e ast hma, di abet es, o r c an c er. Ho wev er, un der t he ACA, i n suran c e c o mpan i es are requi red t o c o v er t hese c o n di t i o n s an d c an n o t c harge hi gher rat es based o n t hem. Thi s pro v i si o n en sures t hat i n di v i dual s wi t h pre-exi st i n g c o n di t i o n s hav e t he o ppo rt un i t y t o get t he c o v erage t hey n eed wi t ho ut fac i n g exc essi v e c o st s o r bei n g den i ed ac c ess t o i n suran c e al t o get her.