ObamaCare Facts: Facts on the Affordable Care Act

ObamaCare Facts 2023 – We Tell you the Facts, Not The Talking Points

We provide up-to-date facts on ObamaCare (the Affordable Care Act). Get the ObamaCare facts on enrollment, assistance, benefits, plan types, and more.

What is ObamaCare?

Obamacare

ObamaCare Facts Image Public Domain, Photo by Chuck Kennedy; U.S. Government Work

The official name for “ObamaCare” is the Patient Protection and Affordable Care Act (PPACA), or Affordable Care Act (ACA) for short.

The ACA was signed into law to reform the health care industry by President Barack Obama on March 23, 2010, and upheld by the Supreme Court on June 28, 2012, and June 17, 2021.

Despite some subsequent court battles and changes to the law, the Affordable Care Act is still “the law of the land ” today. That means all the benefits, rights, and protections discussed below are still in effect.

FACT: Under the Affordable Care Act, the uninsured rate fell to the lowest rate in recent history.

FACT: Before ObamaCare, people could get charged more or dropped from their health plan for being sick in the past.

ObamaCare Basics

Obamacare means cost assistance like tax credits, out-of-pocket savings, and expanded Medicaid. It also means expanded employer coverage and annual open enrollment periods. It also means new rules for insurers. It also means lots of new benefits, rights, and protections for consumers.

That is the basics. However, there are lots of specifics to cover. Let’s start by covering ObamaCare’s main aims and impacts.

ObamaCare Overview

The goal of the Affordable Care Act is to give more Americans access to affordable, quality health insurance and to reduce the growth in U.S. health care spending.

To accomplish this, the ACA expands the affordability, quality, and availability of private and public health insurance through consumer protections, regulations, subsidies, taxes, insurance exchanges, and other reforms.

Below are some of the most important things to know about the law:

FACT: Due to ObamaCare’s cost-curbing provisions, healthcare spending growth has been curbed under the Affordable Care Act. In 2014 costs grew at the slowest rate on record (since 1960). See data from HealthSystemTracker.org and CMS.Gov.

See the video below from HealthCare.Gov, the official Health Insurance Marketplace used to sign up for health plans with cost assistance during open enrollment. Or, keep reading to learn about the Affordable Care Act’s benefits, rights, and protections.

IMPORTANT: Don’t forget to get covered at HealthCare.Gov during open enrollment so you can take advantage of cost assistance options! Those with lower incomes and children should note that Medicaid and CHIP enrollment is offered 365 days a year. Find out what to do if you miss open enrollment.

ACA in the News: The American Rescue Plan and Inflation Reduction Act made many changes to make coverage more accessible and affordable. Here in 2023 many changes are still in effect. For example, the 400% subsidy cliff has been removed through 2025. Learn about the changes to ObamaCare under the American Rescue Plan.

ObamaCare’s Key Benefits, Rights, and Protections

Below is a quick rundown of the most important benefits, rights, and protections in the Affordable Care Act. Decide for yourself what you think about the health care law, based on the ObamaCare facts and not the ObamaCare talking points.

ObamaCare offers some new benefits, rights, and protections:

FACT: ObamaCare gives tens of millions of women access to preventive health services and makes it illegal to charge women different rates than men. Get more ObamaCare women’s health services facts.

FACT: Over 50 million Americans with private health insurance now have access to preventive services with no cost-sharing because of the new minimum standards of ObamaCare.

FACT: 1 in 2 Americans technically have a “preexisting” condition. That means 1 in 2 have a condition that they could have been charged more for or even denied coverage for in some states before the Affordable Care Act. The ACA chipped away at preexisting conditions until 2014 when discrimination against them was banned. Today preexisting conditions are no longer a barrier to insurance coverage for anyone, including high-risk customers. This means you can no longer be denied coverage or treatment or be charged more due to your health status.

Getting Coverage and Cost Assistance Under the Affordable Care Act

The Affordable Care Act’s annual open enrollment period is the only time of year in which individuals and families who don’t qualify for other coverage (like Medicare or Employer coverage) can enroll in coverage that offers the benefits of the Affordable Care Act (like cost assistance and protection for preexisting conditions) without qualifying for a special enrollment period.

Remember, options outside of open enrollment are limited to Short-Term Health Insurance, Medicaid, and CHIP. Keep in mind employer coverage and Medicare have unique enrollment periods. Learn more about enrollment periods.

TIP: If you are getting cost assistance and your income changes throughout the year, make sure to update the Marketplace. If you take too much or too little of Advanced Premium Tax Credits, you’ll have to adjust them at tax time using form 8962.

FACT: Only plans that comply with ObamaCare’s rules qualify for cost assistance and offer all the benefits, rights, and protections ensured by the law. So, for example, short-term health insurance doesn’t have to meet the same standards and doesn’t qualify for cost assistance.

FACT: Americans with private health insurance now have access to preventive services with no cost-sharing because of the new minimum standards of ObamaCare. Only those who qualify for cost assistance can get premium tax credits and out-of-pocket assistance, but the rest of the Affordable Care Act’s benefits are offered to anyone on a major medical health plan obtained after 2014.

FACT: The majority of young U.S. adults will qualify for cost assistance via ObamaCare’s marketplaces, and many will qualify for Medicaid in states that expanded Medicaid due to the average incomes of young adults. Find out how ObamaCare affects young people.

Last year those who shopped around and switched plans saved more. You can shop for quotes on health plans with the help of HealthCare.Gov or a Qualified broker. Are you covered? See tips and tricks related to getting the right health plan.

FACT: Despite rate increases each year, most marketplace users can get a plan for $100 or less due to the ACA’s Advanced Premium Tax Credits cap premiums based on “household income and family size.” Learn more about how cost assistance works with the Affordable Care Act.

FACT: ObamaCare does not replace private insurance, Medicare, or Medicaid/CHIP. If you have Medicare or Medicaid/CHIP, you don’t need to worry about open enrollment and marketplace plans. You are considered to have Minimum Essential Coverage.

FACT: ObamaCare doesn’t regulate your health care; it regulates health insurance along with some of the worst practices of the for-profit healthcare industry.

The video below will tell you Everything You Need to Know About ObamaCare in under 7 minutes. The video below was made in 2014, but everything outside of a few dates is still applicable.

We cover just about everything you could ever want to know about the Affordable Care Act. Scroll down, or use the “find” command on your keyboard, to find what you are looking for. If you don’t find your answer, search the site, read our free ebook, simply ask us, or contact HealthCare.Gov.

Did you know your state can create its own ObamaCare alternative? It is as simple as putting forth a public option, single-payer, voucher, or another system via a 1332 waiver allowed for by the ACA and then getting it passed in your state. So it’s simple, but not easy. Learn more about sec. 1332 forms (it’s how Colorado got single-payer on the ballot).

Tips on Taking Advantage of ObamaCare in 2023

Below are some more facts that will help you take advantage of the benefits and protections offered by the Affordable Care Act:

Consider funding an HSA (Health Savings Account) if you have a High Deductible Health Plan (HDHP). An HSA is a tax-advantaged medical savings account that can lower your tax bracket, qualify you for more tax credits, and lower your out-of-pocket costs on Silver plans while allowing you to use the money you have set aside to pay for your out-of-pocket medical costs with pre-tax dollars.

FACT: Aside from the HealthCare.Gov website, you can also sign up for the marketplace by mailing in an online application (read these instructions first), get in-person help, or call the 24/7 helpline 1-800-318-2596 (TTY: 1-855-889-4325). Learn more about other ways to sign up for health insurance.

On TrumpCare: Sometimes healthcare reform under Trump, especially when it made changes to the ACA, was called “TrumpCare.” A few things changed from 2017 – 2020 under the Trump administration (including an executive order that impacted the mandates and a set of new rules that shortened 2018 open enrollment, allowed for higher out-of-pocket costs, and allowed for narrower networks). There was not however a repeal and place plan passed through Congress, nor did Trump himself repeal the ACA. Until further notice, ObamaCare is still “the Law of the Land.” Repeal and replace attempts in 2017 included the American HealthCare Act, the Better Care Reconciliation Act of 2017, and the Graham-Cassidy Proposal.

TIP: Keep in mind, we could see another “repeal and replace” effort in the future. That means we could see a push to reconsider Republican-favored provisions featured in past bills. Republicans have favored tax credits based on age, expanded HSAs, privatizing “block-grants” for Medicaid, defunding Medicaid, having the flexibility to create stricter rules for Medicaid (such as work requirements), bringing back high-risk pools, defunding of Planned Parenthood, the eliminating the individual and employer mandates, eliminating of out-of-pocket cost assistance, and taxes on industry.

Is ObamaCare Working?

Although statistics on the ACA change each year, we can look at some past data to show the ACA is working.

First off, according to Gallup data, the uninsured rate under the Affordable Care Act (ObamaCare) dropped to record lows of 10.9% in 2016 but since rose to 13.7% in 2019.

By the end of open enrollment 2016, there was estimated to be as many as 12.7 million in the marketplace, and very roughly 20 million total covered between the Marketplace, Medicaid expansion, young adults staying on their parent’s plan, and other coverage provisions.

Today, the enrollment numbers are still impressive and there are still tens of millions of Americans covered under the ACA’s coverage provisions! Consider, in 2020 the total enrolled in HealthCare.Gov and state marketplaces in 2020 was 11.4 million. Meanwhile in 2019 14.8 million were covered by Medicaid expansion and about 2.6 million were able to stay on their parents’ plan, and in 2015, it was estimated that 9.6 million had gained coverage due to the employer mandate.

Enrollment numbers aside, new data is coming out each month that helps to show that key provisions of the ACA are working (like the 50% reduction in bankruptcies from 2010 to 2016).

If you ask Obama himself about the ACA and the Future of US Health Care, he’ll tell you that most of the program is working better than expected, but there is still more work to be done. This message is mirrored even by some of his biggest critics… even Donald Trump’s own administration released a report showing how the Affordable Care Act is working (see: Reforming America’s Healthcare System Through Choice and Competition).

With that in mind, there are parts of the ACA that need more help, and even supporters of the law are in favor of real reforms that improve coverage and costs without increasing the uninsured.

We can summarize the pros and cons of the Affordable Care Act as:

In all, the latest news is good news about total costs and coverage.

For example, a June 2016 study by the Urban Institute shows the latest long-term spending projections are $2.6 trillion less than the original post-ACA baseline forecast through 2020 — a reduction in projected spending of almost 13%. Read more. Meanwhile, the uninsured rate was estimated to hit an all-time low fell to 9.1% in 2015 according to a 2016 report. Another report demonstrated a steady falling trend under the ACA but estimated it at an all-time low of 11%.

Meanwhile, a 2019 report from the Trump administration showed the ACA was still working despite changes under the Trump administration.

FACT: ObamaCare doesn’t ration health care. It protects consumers from the healthcare coverage and cost-based rationing that insurance companies have been doing for decades.

FACT: According to a 2019 Kaiser Family Foundation poll, the majority of Americans support lowering prescription drug prices and ensuring the ACA’s pre-existing conditions protections, while a minority support repealing and replacing the ACA.

NOTE: See the current marketplace sign-up numbers here; despite ebbs and flows throughout the year, the enrollment numbers are growing consistently on average.

FACT: Studies have shown that anywhere from 20,000 to 44,000 Americans died each year from lack of health insurance before the ACA.

FACT: In 2010, 19.5% percent of uninsured were employed, and 14.7% maintained full-time employment for the entire year. In 2010, only 53.8% of private-sector firms offered health insurance. The fact is, poor working families were, and still are the most likely to be uninsured. By expanding coverage and cost assistance, the Affordable Care Act helps working families have access to health coverage.

Other milestone achievements of the ACA over the years include:

FACT: 74,424,652 individuals were enrolled in Medicaid and CHIP in June 2017. See June 2017 Medicaid and CHIP Enrollment Data Highlights.

FACT: The ACA turned 8 on March 23rd, 2018. Find out more about how ObamaCare is working to save consumers money and to curb healthcare costs.

FACT: According to CDC data, 75% of all healthcare expenditures go toward treating chronic diseases, many of which are preventable. Chronic diseases cause 7 in 10 deaths each year in the United States.

TIP: Want more ObamaCare facts? A good way to find out about how the Affordable Care Act is working is to check out the 100 page 2016 White House Report. Most of the information in there remains relevant even as time moves on. See our summary of the ObamaCare White House Report December 2016. For something more recent, see the 2019 report done by the Trump administration.

Why did we need healthcare reform? ObamaCare was enacted to address the “healthcare crisis” (a term that describes the fact that premiums were rising faster than inflation, that healthcare spending was raising as a percentage of GDP, and that the uninsured rate was increasing because of this). The ACA was a first step to solving our problems and their effects like bankruptcy due to medical debt, but it wasn’t the final step. There are still “sticking points” that need to be “fixed.” So far, the biggest gains have been made in states that embraced ObamaCare. The states that rejected key provisions like Medicaid Expansion and the exchanges bring down the national average as their costs are higher, their choice of insurers are fewer, and their uninsured rates are higher. The conscious effort to obstruct ObamaCare at a state and federal level has been actively contributing to the ability of critics of the law to spin the “death spiral” talking point. See facts on how the ACA is working and more facts on the healthcare crisis before the ACA and why we needed reform.

Free Preventive Services and Ten Essential Benefits

Above we covered the ACA’s main benefits, but let’s talk about them in detail.

ObamaCare’s new benefits, rights, and protections include the requirement that most non-grandfathered (or non-grandmothered) health insurance plans cover preventive services and services from at least ten categories of essential health benefits with no annual or lifetime dollar limits. Learn more about grandfathered health plans.

The Ten essential health benefit categories include outpatient care, emergency care, hospitalization, maternity and newborn care, mental health services and addiction treatment, prescription drugs, rehabilitative services and devices, lab services, pediatric dental and vision, and free preventive services.

FACT: Any insurance plan that starts after 2014 must follow new health insurance rules and include Ten Essential Benefits. All health plans sold through the health insurance marketplace adhere to these rules.

FACT: Policies issued before 2010 (“grandfathered” health plans) and short term health plans don’t have to adhere to all the new rights and protections offered by the Affordable Care Act.

FACT: According to the CDC, 75% of all healthcare expenditures go toward treating chronic diseases, many of which are preventable. Chronic diseases cause 7 in 10 deaths each year in the United States. The Affordable Care Act includes a major focus on wellness; this includes funding for programs that educate the public on health and wellness and new rules for employer wellness programs.

FACT: ObamaCare provides free preventive women’s services, including mammograms, as one of the 10 essential benefits covered under every new insurance plan. The Fact is, ObamaCare gives tens of millions of women access to preventive health services and makes it illegal to charge women different rates than men. Get more ObamaCare women’s health services facts.

ObamaCare, Taxes, Shared Responsibility, and Exemptions

The Affordable Care Act also includes a lot of benefits, but it also includes new taxes.

Most of the new taxes are on high-earners, large businesses, and the healthcare industry. However, there are some tax-related provisions every American should be aware of.

These are: tax credits to subsidize costs for low-to-middle income Americans and small businesses, which started in 2014; an Employer Mandate for large employers to provide health insurance to full-time employees by 2015/2016 or pay a fee; an Individual Mandate for individuals and families obtain health insurance or pay a fee which started in 2014; and lastly, new limits on medical deductions.

UPDATE 2019: Remember, the mandate’s fee is reduced to zero for 2019 forward in most states. With that said, since it is still relevant in past years, below are a few more ObamaCare facts about the fee.

UPDATE 2019: Despite efforts to repeal the employer mandate by Republicans, the employer mandate is still the law moving forward.

TIP: The next two points only apply to cases in which the fee would be owed.

The only way for the IRS to collect the fee for not having health insurance is to withhold the money you would get back after filing your federal income tax returns. The IRS cannot enforce the Individual Shared Responsibility Provision with jail time, liens, or any other typical methods of collection. Please keep in mind, about 75% of Americans got a refund in 2012, and many who aren’t owed a refund will be exempt from the tax anyway each year.

Due to a “short coverage gap” exemption, you can go “less than three months” consecutively without coverage during each calendar year and not owe the fee. This means two full months, plus at least one day of coverage for the third month. This primarily protects folks who have downtime between coverage options while they obtain new coverage, but it can also offer flexibility to those who enroll late and have plans that start after January (enrolling late may be an option in states that extend the deadline into January). The exemption also qualifies you for a 60 day Special Enrollment Period.

What is the Health Insurance Marketplace?

ObamaCare creates state-specific and federal health insurance marketplaces (also known as exchanges) where individuals and families can shop for subsidized health insurance based on income.

Get covered: HealthCare.gov is the official site on the Affordable Care Act and the Health Insurance Marketplace. Ready to sign up for health insurance? Find your state’s health insurance marketplace now.

Should I buy insurance through the health insurance marketplace? Your options for obtaining coverage are changing. For some of us, buying private insurance through the health insurance marketplace will be our best option; for others, buying health insurance through a private broker will be the smarter move. Find out which option is right for you and your family. ObamaCare and health insurance plans.

If you like your doctor, you can basically keep them: If you like your doctor, and your health insurance provider includes your doctor in your network, you can keep your doctor. Nothing in the ACA prevents you from keeping your doctor, although you have to pick a network that your doctor participates in… and so some people do run into the problem of not being able to keep their doctor when they change plans. Learn more about ObamaCare and doctors.

FACT: If you don’t have coverage, you can use your state’s Health Insurance Marketplace to buy a private insurance plan. Many Americans will qualify for lower costs on monthly premiums and out-of-pocket costs through the marketplace. Please note that if you have access to employer-based insurance, you cannot get cost assistance through the marketplace.

ObamaCare and Minimum Essential Coverage

Only certain types of major medical health insurance protected you from the Individual Mandate’s shared responsibility fee (the fee for not having coverage) when it was applicable. This type of coverage is called minimum essential coverage.

From 2019 forward Minimum Essential Coverage doesn’t mean as much regarding the fee, but it is still a standard that denotes coverage that meets the standards of the ACA.

ObamaCare and Cost Assistance

Above we touched on the basics of getting covered and getting cost assistance; below, we’ll offer some additional details.

There are three ways to save money on your health insurance through ObamaCare’s marketplaces. First, Advanced premium tax credits, which lower your monthly premium costs. Second, Cost Sharing Reduction subsidies, which lower your out-of-pocket costs for copays, coinsurance, deductibles, and out-of-pocket maximums. Lastly, Medicaid and CHIP, which do both. Learn more about ObamaCare cost assistance.

FACT: The primary reasons for Americans being uninsured are cost and job loss. The ACA helps to curb costs.

FACT: ObamaCare takes measures to prevent all types of discrimination in regards to your right to health care. Insurance companies can no longer use factors such as pre-existing conditions, health status, claims history, duration of coverage, gender, occupation, and small employer size org industry to increase health insurance premiums.

FACT: The only factors that can affect premiums of new insurance plans starting in 2014 are your income, age, tobacco use, family size, geography, and the type of plan you buy. This applies to all plans sold through your State’s health insurance marketplace.

FACT: The amount of out-of-pocket costs your health plan covers can affect your rates. Plans that cover more out-of-pocket costs like deductibles, coinsurance, and copayments also have higher premiums.

FACT: KFF.org estimated that 3.5 million people qualified for an estimated average premium subsidy of $2,890 per person in 2014. The CBO estimated that the average subsidy in 2015 would be $3,900. In 2017 the average premium subsidy was about $4,452 according to KFF.org. These numbers help us to understand that each year cost assistance ensures that those who qualify for assistance will pay low rates, even when premiums increase! This is due to the way cost assistance caps premiums and out-of-pocket spending based on family size and income.

FACT: Medicaid and CHIP are types of cost assistance. Medicaid and CHIP enrollment in 365 days a year. That means there is never a wrong time to apply for Medicaid and CHIP!

MAGI and FPL

Cost assistance is based on Modified Adjusted Gross Income (MAGI). That means the cost is based on your income after most deductions. Once you know your MAGI, you can use the Federal Poverty Level (FPL) Guidelines to determine your assistance amount.

As long as you have the right documents, you can simply fill out a marketplace application, and it will calculate cost assistance for you. However, knowing how MAGI and the Federal Poverty Guidelines work will allow you to make smart choices about how many advanced tax credits to take upfront.

Each year you’ll use last year’s guidelines for determining this year’s assistance amounts. For example, the 2020 Federal Poverty Guidelines are used to determine cost assistance for marketplace coverage for this year. Don’t worry though; the marketplace can help you figure out your assistance amounts. They are calculated when you sign up and give your information!

TIP: If you don’t have access to cost assistance or want to see other private plan options available, you can shop for health insurance quotes outside of the marketplace too. Qualified health insurance brokers and agents outside of the marketplace can even help you shop for marketplace plans. Just make sure you choose a marketplace plan if you want cost assistance, and of course, make sure you choose a broker or agent who is qualified to help you enroll in one if this is the direction you want to go.

Medicaid and CHIP

ObamaCare Expanded Medicaid and CHIP to millions of Americans. You can apply for Medicaid or CHIP at any time of the year.

If you miss open enrollment, you can still sign up for Medicaid and CHIP, but you won’t be able to use the marketplace to do so. Medicaid / CHIP eligibility differs in each state because many states did not expand Medicaid.

There are millions of Americans eligible for Medicaid who simply haven’t signed up yet. Keep spreading awareness and educate yourself about which states have expanded Medicaid eligibility under Medicaid Expansion.

Below are some figures from 2014, since then a few states have expanded Medicaid:

FACT: States that moved forward with Medicaid expansion and established marketplaces saw the biggest reduction in the number of uninsured under the ACA; states that rejected both saw the smallest reduction. Learn more about how ObamaCare affects uninsured rates.

ObamaCare and Employers

ObamaCare helps to cover working families who don’t have access to health insurance.

This new rule is unofficially called the employer mandate. Here are some more facts about ObamaCare and business.

UPDATE: The Trump administration has made some changes to the way the ACA affects businesses. Please see a professional for the latest rules and regulations.

FACT: Only roughly the top 3% of small businesses have to pay their portion of the additional 0.9% ObamaCare Medicare tax increase. Meanwhile, only 0.2% of businesses had over 50 full-time equivalent employees and didn’t already offer insurance to their full-time workers before the ACA.

FACT: Over half of all uninsured Americans are small business owners, employees, or their dependents. Learn the truth behind the ObamaCare small business taxes and how they affect America’s biggest job creators.

ObamaCare and Medicare

ObamaCare gives seniors access to cheaper drugs and free preventive care, reforms Medicare Advantage, and closes the Medicare Part D ‘donut’ hole. The fact is, the Affordable Care Act focuses heavily on ensuring better care for seniors and keeping Medicare strong for years to come. Learn about how the Affordable Care Act affects Medicare.

Medicare isn’t part of the Health Insurance Marketplace. If you have Medicare, keep it.

Do you want to get a better idea of how the Affordable Care Act affects Medicare, Medicare Advantage, Part D, or Medigap policies? Or perhaps you have questions about how Medicare works or how Medicare enrollment works. Look at our section on ObamaCare and Medicare for the Facts on ObamaCare and Medicare reform.

FACT: By 2015 over 100 million Americans had already benefited from the Affordable Care Act. This includes more than 105 million people who accessed critical preventive services for free that had previously been subject to out-of-pocket costs. Seniors saved billions of dollars from the gradual closing of the Medicare Part D “Donut Hole.” Billions more were saved from new accountability measures for insurance companies, and that isn’t even the end of the savings from the ACA.

FACT: Aside from the “key provisions” of the Affordable Care Act (ObamaCare), there are hundreds of provisions that are very effective but rarely talked about. For example, section 3022 of the PPACA includes guidelines for the establishment of Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program (MSSP). ACOs are doctors who band together and get paid based on their patients’ medical outcomes rather than on how many tests and procedures they perform.

FACT: ObamaCare’s new Medicare Value-Based Purchasing Program means hospitals can lose or gain up to 1% of Medicare funding based on a quality vs. quantity system. Hospitals are graded on a number of quality measures related to the treatment of patients with heart attacks, heart failures, pneumonia, certain surgical issues, re-admittance rate, as well as patient satisfaction. Learn more about ObamaCare and Medicare.

Qualified Health Plans

There are 4 types of Qualified Health Plans, sometimes called metal plans, available on the marketplace.

Each one has the same benefits, rights, and protections, but each has different networks and cost-sharing.

As a rule of thumb, the more “valuable” the metal, the higher the premium and lower the out-of-pocket costs. Don’t buy health insurance without understanding actuarial value and deductibles. The cheapest up-front cost option won’t always be the best, or least expensive overall, one for you and your family. Learn about the types of health plans sold on the marketplace.

If you plan to get a high deductible Bronze plan due to cost, consider the perks of a Marketplace Silver plan first. The lower your income, the better a Silver plan becomes. Learn more about ObamaCare’s plan types. Remember only Silver plans qualify for out-of-pocket cost assistance!

Aside from the 4 basic “metal” health plan types, a “catastrophic” health plan is available through the health insurance marketplace for people under 30 and people with hardship exemptions. Catastrophic health plans tend to have a low premium, but very high out-of-pocket costs.

How Health Insurance Works

Have you been wondering how health insurance works? You pay a premium for every month you have coverage. The higher your premium, the smaller your out-of-pocket expenses (copays, coinsurance, deductibles, out-of-pocket maximums) will be and the larger network of doctors and providers you can utilize.

FACT: Since 2014 all plans sold have had to offer the benefits, rights, and protections regarding cost and coverage, but each plan can offer unique costs, networks, and benefits within those limits. Learn more about how health insurance works and how to buy health insurance each year.

Getting covered is only half the battle; find out how your health insurance works by watching a video from The Kaiser Family Foundation.

FACT: ObamaCare allows newly insured Americans to choose any available participating primary care provider, OB-GYN, or pediatrician in their health plan’s network or emergency care outside of the plan’s network without a referral. Because of this provision, networks are very important to consider when choosing a plan as they can affect what in-network providers you have access to.

The History of the ACA

FACT: ObamaCare is a nickname for a healthcare law signed by President Obama in 2010 called the Patient Protection and Affordable Care Act (PPACA). People generally refer to the final amended version of the law, the Health Care and Education Reconciliation Act, and all the subsequent changes together as The Patient Protection and Affordable Care Act, PPACA, Affordable Care Act, ACA, and/or ObamaCare.

FACT: The nickname “ObamaCare” was given to the Affordable Care Act by critics of the law in an effort to associate then-President Barack Obama with healthcare reform efforts. The name was used because Obama championed healthcare reform as a candidate in 2008, and then as a President, before signing the ACA into law in 2010. The name stuck, and Obama embraced it over time, at one point saying, “I kind of like the term ‘Obamacare,’ Because I do care. That’s why I passed the bill.” Today many people know the Affordable Care Act by its nickname.

PPACA In-Depth

For those who want to dig deeper into the PPACA, below are some things to consider.

STILL WANT MORE OBAMACARE FACTS? We’ve created a detailed ObamaCare Facts Health care reform timeline of every protection, benefit, and tax laid out by the Affordable Care Act from 2010 to 2022.

More ObamaCare Facts

Get more ObamaCare Facts in our ObamaCare Facts by checking out the links above or see our archived ObamaCare facts from past years.

IN CLOSING: Despite some recent changes, ObamaCare is still “the law of the land.” With that said, as time has clearly illustrated, there are still many people who would like to see ObamaCare repealed. If ObamaCare is repealed and not replaced with equivalent protections, tens of millions of Americans could be without access to affordable health coverage, and insurance companies will continue to be able to deny coverage for pre-existing conditions. Without healthcare reform, America will continue to suffer the consequences of a health care system controlled by private, for-profit companies whose bottom line is money and not health. Help ObamaCareFacts.com to spread the facts about health care reform under the Affordable Care Act.

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ObamaCare Facts 2019: Facts on Everything Related to the Affordable Care Act

Author: Thomas DeMichele

Thomas DeMichele is the head writer and founder of ObamaCareFacts.com, FactsOnMedicare.com, and other websites. He has been in the health insurance and healthcare information field since 2012. ObamaCareFacts.com is a.

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