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What's in the Affordable Care Act?

The Affordable Care Act, signed into law in March 2010, has made it easier for people to access health coverage by:

Expanding Access

  • Expanded Medicaid eligibility to 138% FPL ($16,105 individual/$32,913 family of four) and allows states to cover parents and childless adults. For more information, visit our Medi-Cal Expansion page
  • Created regulated health insurance marketplaces, in which consumers can purchase coverage plans. Those earning up to 400% FPL ($46,680 individual/$95,400 family of four) are eligible for tax credits to purchase affordable coverage. For more information, visit our Covered California page.
  • Included $11 billion in additional funds for community clinics.
  • Permanently reauthorized the Indian Health Care Improvement Act.

Promoting Health Equity and Prevention

  • Established Offices of Minority Health (OMH) in federal agencies.
  • Standardized data collection for race, ethnicity and primary language.
  • Established the Prevention and Public Health Trust Fund. For more information, visit our Prevention and the ACA page
  • Required Medicare & private insurers to provide free preventive services.
  • Increased funding for school-based health centers.
  • Required nutrition labeling for large restaurant chains.

Reforming the Private Insurance Market

  • Prohibited insurers from:
    • instituting lifetime and annual coverage limits in 2014.
    • rescinding coverage based on new diagnoses (known as "rescission").
    • denying coverage based on pre-existing health conditions.
  • Allowed children up to age 26 allowed to be on parent’s insurance plan.
  • Required insurers to:
    • provide access to free preventive services.
    • use 80 cents out of every dollar of premiums collected to pay claims or improve services (known as "Medical Loss Ratio").
    • provide standardized summary of benefits and coverage.

Modifying the Employer-Sponsored Insurance Market

Included the following mandates for certain employers, effective in 2015:

  • Large employers: 50 full time employees (FTE) or more
    • Must provide health insurance or pay a fine
      • $2,000 for every FTE beyond first 30 
      • $3,000 if coverage offered but not affordable (i.e. employee eligible for tax credit subsidies in the Exchange)
    • No penalty for part-time workers (30 hours or less)
  • Small employers: fewer than 50 FTE
    • 50 FTE or less = exempt from mandate 
    • Employers with 25 FTE or less with an average wage less than $50,000 annually are eligible for tax credits to encourage them to offer coverage
      • 50% tax credit 2014 if purchase in the employer exchange
      • Non-profits also qualify for 35% tax credit

Diversifying the Health Care Workforce

  • Included funds for scholarships and student loan repayment to incentivize medical providers to work in areas that do not have enough health professionals. For more information, check our ACA Workforce page.