Affordable Care Act

According to the Census Bureau, nearly 50 million Americans do not have healthcare coverage. Without healthcare reform, it is estimated that this number will rise dramatically over the next several years.

In March 2010, President Obama signed the Affordable Care Act. The overall goal of this legislation is to increase access to quality, affordable healthcare for uninsured individuals and their families. Through the new law, which will be implemented in phases over the next several years, health insurance will be extended to approximately 32 million Americans.

In September 2010, several provisions of the law went into effect and may impact you and your family. These include:

  • Providing access to insurance for individuals with pre-existing conditions
  • Extending coverage for young adults - up to age 26 - on their parents' plans
  • Providing free preventative care, such as immunizations and mammograms
  • Ending lifetime and most annual limits to care

On June 16, 2011, the National Prevention, Health Promotion, and Public Health Council announced the release of the National Prevention Strategy, a comprehensive plan intended to help increase the number of Americans who are healthy at every stage of life. The National Prevention Strategy provides an unprecedented opportunity to shift the nation from a focus on sickness and disease to one based on wellness and prevention. It presents vision, goals, recommendations and action items that public, private, nonprofit organizations and individuals can take to reduce preventable death, disease and disability in the United States. For more information on the National Prevention Strategy, visit www.surgeongeneral.gov/initiatives/prevention/strategy/.

Through the Health Insurance Marketplace, which opened October 1, 2013, uninsured individuals and families can research, compare, and find the best health coverage options based on their needs and budget. Using one application, you can see which plan or plans may be best for you. And, you can determine if you or your family members qualify for Medicaid or the Children’s Health Insurance Program (CHIP).

Affordable Care Act Requires Marketplace Plans Include Essential Benefits

As part of the Affordable Care Act, all health plans offered in the marketplace must provide core set of essential benefits within the following ten categories.

  • Ambulatory patient services, such as doctor's visits and outpatient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care

All health plans are provided by private insurance companies, but depending on where you live, the marketplace may be run by your state or the federal government. If your state has its own marketplace, you will enroll through your state’s marketplace website. To learn what marketplace is available in your state, scroll over your state on our map and a call-out box will tell you which website to use to apply for coverage. You can also find this information at www.healthcare.gov.

Enrollment in the available health plans begins October 1, 2013 and ends March 31, 2014. Coverage with these plans starts January 1, 2014.

For more information about the Affordable Care Act and the Health Insurance Marketplace, visit www.healthcare.gov.

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