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Health Care Reform:

Health Insurance & Affordable Care Act

Back to ACA Health Insurance Terms List

Affordable Care Act

The Affordable Care Act is the law that has led to health care reform. Under the law:

Most people will have to buy health insurance or pay a penalty. This is called the individual mandate.

Each state has access to a Marketplace, also called an Exchange, where you can buy health insurance. It is available to you online, on the phone, or in person. You can see health plans being sold through the government-run exchanges for your state in one place.

You may be eligible for financial aid, called subsidies, to buy insurance. How much aid you get depends on how much you make a year, how many people are in your family, and where you live. Many families of four with an annual income less than $95,400 a year will get some financial help.

Your children can stay on your plan until they turn 26.

If you have a health problem, you must be accepted by any health plan you want. You cannot be denied coverage because of a pre-existing condition or be charged more for coverage based on your medical condition.

Even if you have a chronic condition or a serious accident, your health plan has to cover a list of essential health benefits. You can get the care you need for the services on the list of essential health benefits without worrying that your health plan will stop paying its part.

A chronic condition is one that can't be cured but isn't immediately life threatening. Some chronic conditions are allergies, arthritis, asthma, diabetes, and heart disease.

Essential benefits include doctor visits, emergency services, staying in the hospital, maternity and newborn care, prescriptions, and others.

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Health Insurance Terms

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