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Health Insurance Reform Overview

In 2010, the Affordable Care Act was signed into law. This law, often referred to as “healthcare reform” or “Obamacare”, changes the rules of healthcare and health insurance for patients, employers, and insurance companies. Below is a summary of some of the major changes brought about by the healthcare reform.

Individual mandate

Starting in 2014, most people will be required to either have health insurance or pay a fee. If you are eligible for Medicare or meet certain other exceptions, you may be exempt from this. In addition, people under 30 or those with a sufficiently low income may be able to satisfy the insurance requirement with certain “catastrophic” plans that protect from extremely high medical expenses.

Coverage for preventative care

Health insurance plans are now required to cover certain preventative care services with no out-of-pocket costs to the patient. Preventative care services include things like immunizations, cancer screenings, and annual physicals.

Coverage for dependents up to age 26

Parents who have employer-sponsored health insurance plans that offer coverage for dependents may now cover their children until age 26. This is true even if the child is no longer living at home, is married, or is not financially dependent on his or her parents.

Pre-existing conditions

Starting in 2014, insurance companies can no longer deny an applicant because the applicant has a pre-existing health condition. They also cannot charge more for people with pre-existing conditions.

No lifetime or yearly dollar limits

Insurance plans can no longer place a maximum annual or lifetime limits on how much they will spend on an individual’s claims for essential healthcare benefits.

The Marketplace

The Marketplace is a government-run online exchange for shopping and purchasing health insurance. Some states run their own Marketplaces, others use the federal Marketplace. If you purchase insurance from the Marketplace and you meet certain income criteria, you may be eligible to receive a subsidy or other assistance from the federal government to help you pay for insurance.

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