What are the main features of the ACA that expand health insurance coverage? 

What are the main features of the ACA that expand health insurance coverage?


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jameadows eNotes educator| Certified Educator

The Affordable Care Act (ACA), also referred to as Obamacare and passed in 2010 under President Obama, refers to two acts: the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. Together, these two acts expand healthcare coverage by requiring private healthcare companies to accept every applicant and charge the same rates, regardless of the applicant's pre-existing medical conditions. Insurance plans can also not drop people who become sick. In addition, the act requires states to insure individuals and families with incomes up to 133% of the federal poverty level through Medicaid.

In addition, the program to enroll children in CHIP (State Children's Health Insurance Program) became streamlined, making it easier for parents to apply for and receive health coverage for their uninsured children. Children can also receive coverage through their parents' plans until the age of 26. Finally, people with incomes in the range of 100% to 400% of the federal poverty level can receive subsidies, in the form of tax credits, to buy healthcare on a federal exchange. 

People who do not purchase healthcare coverage through their employer, Medicare, Medicaid, or another program are required to pay a penalty. In addition, employers with 50 or more employees are also required to provide healthcare coverage or pay a penalty. 

Although this legislation has been highly politically contentious, with general Democratic support and Republican opposition (with opposition also coming from the Tea Party movement, small businesses, and some labor unions), it has reduced the number of uninsured people in the U.S. In 2016, a Gallup poll found that the percentage of adults who were uninsured dropped from 17.1% to 11%. Public opinion on the law is also divided, with white people more opposed to it than African American and Hispanic people.