Health Care that Works for Americans
On March 23, 2010, President Obama signed the Affordable Care Act into law, putting in place comprehensive reforms that improve access to affordable health coverage for everyone and protect consumers from abusive insurance company practices.
If you are one of the millions of Americans who gets health insurance through work or through a program like Medicare, you are benefiting from rights and consumer protections. The law is making sure consumers and their doctors — not insurance companies — are in charge.
If you are uninsured or are struggling to find affordable health insurance, the health care law brings you options to get covered. A Health Insurance Marketplace in every state offers consumers a choice of private health plans. If you don’t have health insurance, you can qualify for financial help to lower the cost of premiums in the Marketplace, and many Americans can get a plan for less than $100 per month. Learn more and sign up for coverage at HealthCare.gov.
Understanding the Reforms
Here are the key facts about the Affordable Care Act.
Consumer Rights and Protections
In the past, insurance companies could take advantage of you. They could deny coverage to children who had asthma or were born with a heart defect, put a lifetime cap on the amount of care they would pay for, or cancel your coverage when you got sick just by finding an accidental mistake in your paperwork. The Affordable Care Act creates a Patient’s Bill of Rights that protects you from these and other abusive practices.
End to Pre-Existing Condition Discrimination: Insurance companies can no longer deny coverage or charge more because of a pre-existing condition.
End to Limits on Care: In the past, some people with cancer or other chronic illnesses ran out of insurance coverage because their health care expenses reached a dollar limit imposed by their insurance company. Under the health care law, insurers can no longer impose lifetime dollar limits on essential health benefits and annual limits are being phased out by 2014. More than 105 million Americans no longer have lifetime limits thanks to the law.
End to Coverage Cancellations: Insurance companies can no longer drop your coverage when you get sick due to a mistake you made on your application.
More Affordable Coverage
The law helps you by bringing down health care costs and making sure your health care dollars are spent wisely. Insurance companies will now be accountable to their customers for how they are spending premium dollars, and how much they are raising rates. Plus, the law will help lower costs through tax credits and marketplaces where insurers will have to compete for your business.
Value for Your Premium Dollar: Thanks to the Affordable Care Act’s 80/20 rule, if insurance companies don’t spend at least 80 percent of your premium dollar on medical care and quality improvements rather than advertising, overhead and bonuses for executives, they will have to provide you a rebate. Consumers have already received nearly $2 billion in rebates.
Strengthening Review of Rate Increases: In every state, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more.
Help Paying for Premiums: Millions of Americans who don’t get coverage at work are getting financial assistance to lower their monthly premiums, cutting their costs and making insurance affordable.
Improving Affordability: Since the Affordable Care Act was enacted, health care prices have risen at the slowest rate in nearly 50 years.
Better Access to Care
The health care law builds on what works in our health care system. And it fixes what’s broken by providing you with more health insurance choices and better access to care.
Free Prevention Benefits: Insurers are now required to cover a number of recommended preventive services, such as cancer, diabetes and blood pressure screenings, without additional cost sharing such as copays or deductibles. 137 million Americans with private health coverage have gotten better preventive services coverage as a result.
Coverage for Young Adults: Under the law, most young adults who can’t get coverage through their jobs can stay on their parents’ plans until age 26 – a change that has already allowed 5.7 million young adults to get health coverage and given their families peace of mind.
The Health Insurance Marketplace: The Health Insurance Marketplace is a one-stop shop where consumers can choose a private health insurance plan that fits their health needs. Most people who shop in the Marketplace qualify for financial assistance that lowers their monthly premiums and makes coverage affordable.
Strengthening Medicare
Nearly 50 million older Americans and Americans with disabilities rely on Medicare each year, and the health care law makes Medicare stronger by adding benefits, fighting fraud, and improving care for patients. The projected life of the Medicare Trust Fund has been extended by 13 years to 2030 as a result of reducing waste, fraud, and abuse, and slowing cost growth in Medicare.
Lower-Cost Prescription Drugs: In the past, as many as one in four seniors went without a prescription every year because they couldn’t afford it. To help these seniors, the law provides relief for people in the donut hole – the ones with the highest prescription drug costs. Since 2010, more than 9.4 million people with Medicare have saved over $15 billion on prescription drugs, an average of $1,598 per person. Seniors will continue to see additional savings on covered brand-name and generic drugs while in the coverage gap until the gap is closed in 2020.
Free Preventive Services: Under the law, seniors can receive recommended preventive services such as flu shots, diabetes screenings, as well as an Annual Wellness Visit, free of charge. So far, more than 39 million seniors have already received one or more free preventive services, including the Annual Wellness Visit.
Fighting Fraud: The health care law helps stop fraud with tougher screening procedures, stronger penalties, and technology. The law’s anti-fraud provisions have contributed to several record-high years of health care fraud recoveries. In FY 2014, these efforts recovered $3.3 billion in taxpayer dollars.
Improving Care Coordination and Quality: The Affordable Care Act made major investments in improving the quality and safety of patient care, including for people with Medicare. Fewer Americans are losing their lives or falling ill due to hospital-acquired conditions, like pressure ulcers, central line associated infections, and falls and traumas — which are down 17 percent since 2010. Preliminary data show that between 2010 and 2013, there was a decrease in these conditions by more than 1.3 million events. As a result, 50,000 fewer people lost their lives, and there were $12 billion in cost savings.
Fewer Unnecessary Hospital Readmissions: Reforms to improve the quality of hospital care have helped avoid an estimated 150,000 hospital readmissions between 2012 and 2013.
Lower Premiums: In 2015, Medicare Part B premiums did not increase for the second year in a row. Had Medicare Parts B and D premiums followed the path projected under 2009 policies, a senior enrolled in both parts of the program would pay an additional $431 in premiums in 2015.
"The stories of everyday Americans and, more importantly, the courage it took to share those stories is what kept this effort alive and moving forward even when it looked like it was lost. They are why we got this done. They are why I signed this bill into law."
Reform by State
Find out what's happening in your state and listen to stories from Americans across the country.
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