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    Health Care Reform:

    Health Insurance & Affordable Care Act

    Voter Guide: Health Reform Overview

    The Issue:

    Just over 33 million Americans have no health insurance, down from almost 42 million before the Affordable Care Act was implemented. Health care represents roughly $3 trillion or almost 18% of the nation’s budget, and costs continue to rise. The Medicare trust fund is expected to be unable to meet its financial obligations by 2030. 

    For these reasons and others, most policy makers agree that the health care costs need to be addressed.

    The health reform law passed in 2010, also known as the Affordable Care Act, represents one way to address these issues. The main goal of the law was to expand health insurance coverage to millions of Americans and to protect health care consumers with new regulations placed on the insurance industry. Some candidates want to repeal and replace the law and have different proposals for changing health care.

    Here are highlights of what the law includes, along with its alternatives.

    The Mandate, the Tax, and Coverage for Pre-existing Conditions

    Since Jan. 1, 2014, almost all Americans are required to have health insurance. 

    Those who don't have insurance through an employer can buy it through their state Marketplace. States have the option to expand their Medicaid program to millions of lower-income residents with the federal government paying all of the costs for the first three years. 

    People who don't buy insurance will have to pay a tax penalty. The penalty for the 2016 tax year will be $695 or 2.5% of taxable income, whichever is greater (up to a maximum of $2,085 or the average cost of annual premiums for a bronze level plan). 

    The individual mandate was included to prevent people from waiting until they get sick to purchase health insurance. 

    In addition, insurance companies can no longer deny people coverage because of their pre-existing conditions or to charge them more based on their medical history. 

    Without requiring everyone to purchase insurance, insurers could not afford to cover people with serious medical conditions. If everyone pays for health insurance, the risks can be shared among people who are well and use fewer medical services and those who are sicker and use more.

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