What is the Affordable Care Act
Updated: Jan 30
The Act expanded Medicaid eligibility, created health insurance exchanges, and prevents insurance companies from denying coverage (or charging more) due to pre-existing conditions. It also allows children to remain on their parents’ insurance plan until age 26.
The Affordable Care Act—also known as Obamacare—was signed into law in March 2010. It was designed to extend health insurance coverage to millions of uninsured Americans.
The Act expanded Medicaid eligibility and created a Health Insurance Marketplace. It prevents insurance companies from denying coverage due to pre-existing conditions and requires plans to cover a list of essential health benefits.
Lower-income families can qualify for extra savings on health insurance plans through premium tax credits and cost-sharing reductions.
Understanding the Affordable Care Act (ACA)
The Affordable Care Act was designed to reduce the cost of health insurance coverage for people who qualify. The law includes premium tax credits and cost-sharing reductions to help lower costs for lower-income individuals and families.
All ACA-compliant health insurance plans—including every plan that’s sold on the Health Insurance Marketplace—must cover specific “essential health benefits” including:
Ambulatory patient services
Mental health and substance use disorder services
Pregnancy, maternity, and newborn care
Preventive and wellness services and chronic disease management
Rehabilitative and habilitative services
Special Enrollment Periods
You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child. Depending on your Special Enrollment Period type, you may have 60 days before or 60 days following the event to enroll in a plan.
Qualifying Life Event (QLE)
A change in your situation — like getting married, having a baby, or losing health coverage — that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment Period.
Types of qualifying life events. (The following are examples, not a full list.)
Loss of health coverage
Losing existing health coverage, including job-based, individual, and student plans
Losing eligibility for Medicare, Medicaid, or CHIP
Turning 26 and losing coverage through a parent’s plan
Changes in household
Getting married or divorced
Having a baby or adopting a child
Death in the family
Changes in residence
Moving to a different ZIP code or county
A student moving to or from the place they attend school
A seasonal worker moving to or from the place they both live and work
Moving to or from a shelter or other transitional housing
Other qualifying events
Changes in your income that affect the coverage you qualify for
Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
Becoming a U.S. citizen
Leaving incarceration (jail or prison)
AmeriCorps members starting or ending their service