On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act, commonly known as the Affordable Care Act (ACA) or Obamacare. Together with the Health Care and Education Reconciliation Act amendment, it represented the most significant regulatory overhaul of the U.S. healthcare system since the passage of Medicare and Medicaid in 1965.
Some key points of the law
- Medicaid eligibility expanded to include individuals and families with incomes up to 133% of the federal poverty level, including adults without disabilities and without dependent children.
- For those not eligible for Medicaid states may either set up a state run health insurance exchange or, if they chose not to, their citizen can use the federal exchange to purchase health insurance.
- Low-income individuals and families whose incomes are between 100% and 400% of the federal poverty level will receive federal subsidies on a sliding scale if they purchase insurance via an exchange
- Dependent children will be permitted to remain on their parents' insurance plan until their 26th birthday.
- Insurers are prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays.
- Insurers are prohibited from dropping policyholders when they get sick and cannot refuse to insure someone based on previous medical history or preexisting conditions.
- All new insurance plans must cover preventive care and medical screenings rated Level A or B by the U.S. Preventive Services Task Force. Insurers are prohibited from charging co-payments, co-insurance, or deductibles for these services.
- Women cannot be charged more for insurance and insurance must cover reproductive health services.
- Under the "individual mandate" if an eligible citizen refuses to purchase insurance they will be required to pay a fine. The percentage of the fine increases as the years of the ACA go on.