The Affordable
Care Act

the law that changed the healthcare game

Our Guide to the Affordable Care Act

The Affordable Care Act puts consumers back in charge of their health care. Under the law, a new “Patient’s Bill of Rights” gives the American people the stability and flexibility they need to make informed choices about their health.

View key features of the Affordable Care Act or read a year-by-year overview of features.

Coverage

  • Ends pre-existing condition exclusions for children: Health plans can no longer limit or deny benefits to children under 19 due to a pre-existing condition.
  • Keeps young adults covered: If you are under 26, you may be eligible to be covered under your parent’s health plan.
  • Ends arbitrary withdrawals of insurance coverage: Insurers can no longer cancel your coverage just because you made an honest mistake.
  • Guarantees your right to appeal: You now have the right to ask that your plan reconsider its denial of payment.

Costs

  • Ends lifetime limits on coverage: Lifetime limits on most benefits are banned for all new health insurance plans.
  • Reviews premium increases: Insurance companies must now publicly justify any unreasonable rate hikes.
  • Helps you get the most from your premium dollars: Your premium dollars must be spent primarily on health care – not administrative costs.
  • You may pay a fee as part of your taxes if you didn’t have health coverage in 2015 and do not get an exemption. If you can afford health insurance but choose not to buy it and you are not eligible for an exemption, you may need to pay a fee with your federal tax return. If you didn’t have coverage in 2015, you will have to pay a fee on your federal tax return of $325 per adult and $162.50 per child under 18, or 2% of your income (whichever is higher). In 2016, the fee is $695 per person and $347.50 per child under 18, or 2.5% of your income (whichever is higher). In future years, the fee will be adjusted for inflation.
    • You do not have to pay the fee if you get an exemption. If you ask for and are approved for an exemption, you will not have to pay a fee for not having health coverage. You might be able to get an exemption because of a special situation, like not having any affordable health insurance plans available to you, having only a short gap in coverage, or being eligible for services through the Indian Health Service.

      Coverage to Care

      Coverage to Care is an initiative to help people with new health care coverage understand their benefits and connect to primary care and the preventive services that are right for them.

      ​Health coverage pays for provider services, medications, hospital care, and special equipment when you’re sick. It is also important when you’re not sick. Most coverage includes immunizations for children and adults, annual visits for women and seniors, obesity screening and counseling for people of all ages, and more for free. Keep your coverage by paying your monthly premiums (if you have them).

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