The Affordable Care Act, which people also refer to as ACA, PPACA, or Obamacare, is a federal law concerning health care coverage. The act stems from the Obama Administration’s desire to expand healthcare coverage and Medicaid, as well as encourage innovation. Obama’s signature goes on the ACA in 2010, and the states implement changes by 2014. Last week, we reviewed key Affordable Care Act basics, such as what the Federal Poverty Level is as well as the main purposes of the ACA. This week, we are looking at more Affordable Care Act basics key protections the ACA affords as well as federal provisions that help achieve the ACA’s goals.

Rights & Protections

The ACA affords Americans some very specific rights and privileges. If you get a new insurance plan, these things should be on there. But there are a handful of plans that insurance companies grandfather in, so check your plan for coverage today. So here are some things that plans must do.

  • Cover individuals with pre-existing conditions, as well as not charging more for it.
  • Offer free preventative care.
  • Provide young adults with more options.
  • Abolish lifetime and annual limits on coverage of essential health benefits.
  • Assist customers understand what type of coverage they get.
  • Protect your choice of healthcare provider as well as protect you from retaliation from your employer.
  • Give mothers breastfeeding support and equipment.
  • Birth control counseling and cost coverage.
  • Include mental health and substance abuse services in the category of essential health benefits.
  • Allow people to appeal health plan decisions and have an outside party review them.

The ACA also holds insurance companies accountable for rate increases and prohibits them from dropping a client when that client gets sick.

Federal Provisions

The three main purposes of the ACA are to improve the availability of coverage, expand Medicaid, and support cost saving innovations in health care delivery. There are quite a few steps the federal government takes to achieve those goals. We only have space for some of the provisions on this page, for a full list, check out the National Conference of State Legislatures website. In addition, there are exceptions to a few of these provisions, consult with your local health insurance company to find out further details.

Availability Of Coverage

  • Make employers help their workers get coverage. However, some small businesses are exempt.
  • Give small businesses that help cover employee health insurance costs with tax credits.
  • Insurance plans must cover young adults on parents’ plans.

Medicaid Expansion

  • Give Medicaid coverage to people with incomes below 133% FPL.
  • Improve care coordination between Medicare and Medicaid.
  • Medicaid must cover services to help pregnant individuals on Medicaid stop smoking.

Innovation

  • Comparative studies to research the difference in effectiveness of different treatments. Then, implement that research.
  • Collect and report data to analyze health disparities between populations of different demographics.
  • Invest in health information technology.