skip to main content

Enter Title

Affordable Care Act

Individuals and Family PlansAll About Health InsuranceAffordable Care Act

Text/HTML

Higher-quality healthcare for all Americans

The Affordable Healthcare Act (ACA) is a reform of the United States healthcare system. Aiming to give Americans more affordable, accessible, higher-quality choices in healthcare, it was signed into effect in 2010.

When more people are insured, it helps stabilize healthcare costs for everyone.

ACA gives you rights as a patient

You have protection under the ACA Patient’s Bill of Rights. These rules ensure:

  • You get coverage with preexisting conditions
  • You have the right to choose your doctor
  • You get fair treatment of emergency care
  • Policies aren’t unfairly canceled
  • No more annual and lifetime limits
  • You get access to preventive services
  • You have the right to appeal health plan decisions
  • Coverage for young adults (under age 26)
  • Protection under grandfathered plans

Health Insurance Marketplace plans cover essential health benefits

If you purchase your plan through the Healthcare Insurance Marketplace, it must cover essential health benefits. These essential benefits fall into ten categories:

1. Ambulatory patient services 

Care you can get without being admitted to a hospital, like at a doctor’s office or clinic.

2. Emergency services 

Care for conditions that could result in disability or death if not immediately treated.

3. Hospitalization 

Care you get in a hospital.

4. Laboratory services 

Tests (such as blood and tissue) to help diagnose medical conditions.

5. Maternity and newborn care 

Care for pregnant women and newborns.

6. Mental health services and addiction treatment 

Evaluation, diagnosis, and treatment of mental health and substance abuse issues.

7. Rehabilitative services and devices 

Help people with disabilities, injuries, or chronic conditions with recovery.

8. Pediatric services 

All essential benefits for kids, including oral and vision care.

9. Prescription drugs 

Drugs prescribed by a doctor for treatment.

10. Preventive care 

Includes physicals, screening, immunizations, and chronic disease management for ongoing conditions.

Fees for the uninsured

You pay a penalty if you’re not covered by your employer, Medicaid, Medicare, or another public insurance program. If you have financial hardship or are a member of a recognized religious sect recognized by the IRS, you aren’t required to have healthcare insurance. Otherwise, you must be insured.