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Affordable Care Act (ACA): What It Is, Key Features, and Updates

Still life of a manual handbook for the Patient Protection and Affordable Care Act with a stethoscop... Still life of a manual handbook for the Patient Protection and Affordable Care Act with a stethoscope and prescription medication bottle. The manual is open to the title page, The open enrollment of the Affordable Care Act of the United States offers a health insurance program for all the U.S. citizens across the country.

What Is the ACA?

President Obama signed the Affordable Care Act (ACA) into law in March 2010. The Patient Protection and Affordable Care Act, or Obamacare, provides a list of healthcare policies to cover millions of uninsured Americans.

The law increased Medicaid eligibility, introduced health insurance marketplaces, required Americans to get health insurance, and banned preexisting condition denials.

Understanding the ACA

The ACA aimed to restructure the health insurance sector and lower premiums for eligible individuals. The statute provides premium tax credits and cost-sharing reductions for low-income families.

Most insurance plans, including those provided on the Health Insurance Marketplace, must include checkups, patient counseling, vaccines, and many health screenings at no cost under the ACA.
All ACA-compliant health insurance plans must cover “essential health benefits,” including emergency, family planning, maternity, hospitalization, prescription drugs, mental health, and pediatric care.

The law lets states expand Medicaid coverage. By September 2022, 39 states and DC have exercised that choice.
During open enrollment, people can buy or switch health plans on the Health Health Marketplace every year. Only people who marry, divorce, have children or lose health insurance-covered work can enroll outside of the open season.

Key ACA Features

ACA provisions increase insurance availability, consumer protections, preventive and wellness, quality and system performance, health workforce growth, and healthcare cost reduction.

Increase Insurance Access
The ACA mandates employer coverage and gives small businesses tax incentives for covering employee health insurance costs. It established state- or multistate insurance exchanges for individuals and small companies.

The law expanded Medicaid coverage for low-income people and let young people stay on their parent’s plans until age 26.

Until 2017, the individual mandate required all Americans to get healthcare coverage from an employer, the ACA, or another source or face tax penalties.

Protect Consumer Insurance More

The ACA prevents lifetime monetary restrictions, limits yearly caps, and requires state rate reviews for insurance premium hikes. Insurance companies cannot exclude or cancel coverage for children with preexisting conditions.

Wellness and Prevention

The ACA’s Prevention and Public Health Fund grants states for disease screenings and immunizations, and the National Prevention, Health Promotion, and Public Health Council addresses tobacco use, physical inactivity, and poor nutrition.

The ACA mandates insurance companies to cover vaccines, child preventative care, screening for high blood pressure, high cholesterol, diabetes, and cancer, and oral health education.

Enhance Health and Reduce Costs

The ACA requested health IT investments. It addressed guidelines for preventing medical errors and payment systems to promote efficiency, results, and coordination of provider care.

The law regulates health insurance pricing and practices to reduce healthcare fraud and uncompensated care and encourages insurance exchange comparison shopping to boost competition and price transparency.

Affordable Care Act updates

Since his 2016 victory, President Donald Trump has sought to repeal and replace the ACA, saying the US should delay “the implementation of any provision or requirement of the [Patient Protection and Affordable Care] Act that would impose a fiscal burden on any State.”

In December 2017, the Tax Cuts and Jobs Act (TCJA) eliminated the penalty for not having health insurance. They shortened the ACA enrollment period in half by scaling back the outreach effort. According to a Kaiser Family Foundation estimate, ACA-covered Americans declined to 13.8 million in 2018 from 17.4 million in 2015.

President Biden issued an executive order in 2021 to examine “rules and other policies that limit Americans’ access to health care,” directing federal agencies to examine preexisting conditions, Health Insurance Marketplace policies, enrollment roadblocks, and affordability. The American Rescue Plan Act (ARPA) extended ACA health insurance subsidies to Marketplace buyers with incomes beyond 400% of poverty to combat COVID-19.

After Biden signed the Inflation Reduction Act on Aug. 16, 2022, ACA enrollees received financial support through 2025 instead of 2022. It also increases middle-class premium aid eligibility. The House and Senate passed the bill.

What are common ACA pro- and anti-arguments?

Opponents say the Affordable Care Act (ACA) damages small businesses that must provide insurance, hikes healthcare prices, and makes people rely on government services.

Health insurance advocates say they get medical care quickly and live healthier. They believe the healthcare system will run more efficiently without commercial insurers and customers funding the uninsured.

When does Marketplace annual enrollment begin?
Health Insurance Marketplace enrollment begins Nov. 1. Information is accessible on the government website.

How many people utilize the Health Insurance Marketplace?
More than 13 million people have ACA Marketplace coverage as of 2021.

The Verdict

The 2010 Patient Protection and Affordable Care Act (ACA) is known as Obamacare. Millions of uninsured Americans gained healthcare coverage. The ACA created the Health Insurance Marketplace for qualified consumers to acquire health insurance.

All ACA-compliant health plans, including Marketplace plans, must cover many essential health benefits. The ACA evolved under three presidents.


  • Obamacare is the Affordable Care Act, brought into law in March 2010.
  • ACA coverage was intended for millions of uninsured Americans.
  • The ACA extended Medicaid eligibility, introduced a Health Insurance Marketplace, and banned preexisting condition denials.
  • The Affordable Care Act mandates health insurance coverage of essential benefits.

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