The Affordable Care Act and You

In response to widespread problems in the U.S. healthcare system, the federal government passed a sweeping healthcare reform law in 2010 called the Patient Protection and Affordable Care Act (also known as the Affordable Care Act, the ACA and Obamacare). Provisions included in the ACA are intended to:

• expand access to insurance
• increase consumer protections
• emphasize prevention and wellness
• improve quality and system performance
• expand the health workforce
• curb rising healthcare costs

The ACA requires most people to have health insurance by March 31, 2014, or face a financial penalty. This provision, known as the Individual Mandate, is intended to encourage people to get coverage to protect them against far greater financial losses if they remained uninsured.

A detailed overview of the Individual Mandate can be found on the Kaiser Family Foundation website (http://kff.org/infographic/the-requirement-to-buy-coverage-under-the-affordable-care-act/). While most U.S. residents had health insurance prior to passage of the ACA through their job, the government (Medicare, Medicaid, CHIP, Military or the Veterans Administration) or insurance companies by directly purchasing policies, far too many people lacked health insurance. Uninsured people generally either cannot get appropriate medical care, or they do get care with significant consequences — major financial debt and higher healthcare costs for us all.

In response, the ACA increased the number of people who can qualify for Medicaid and created Internet-based marketplaces (also known as exchanges) regulated by the government. Medicaid expansion was intended for the whole country as written in the ACA. However, the U.S. Supreme Court ruled that the federal government does not have the power to require states to do so. This ruling made Medicaid expansion a choice for each state. For 2014, Delaware and New Jersey have expanded Medicaid, but Pennsylvania has not. The rest of the ACA was upheld as constitutional by the court. (For more information on what expansion may mean to you and your family, go to: www.healthcare.gov/what-if-my-state-is-not-expanding-medicaid.

The ACA marketplaces are designed to help those who purchase non-employer-based private insurance by granting access to group rates and minimum coverage requirements, and by helping them understand and compare plans more easily. Additionally, some people can qualify for financial help from the government to pay for their insurance. The marketplaces are primarily websites, but it is important to note that toll-free telephone numbers with extensive language services and information for finding knowledgeable in-person assistance are also available online. Marketplaces and information can be found at www.healthcare.gov and Consumer Protections can be accessed at www.healthcare.gov/how-does-the-health-care-law-protect-me.