- Obamacare – aka the Affordable Care Act – was signed into law by President Barack Obama in 2010.
- The law was intended to make health coverage on the individual market more affordable – for millions.
- The ACA’s included more than 1,000 pages of provisions to improve coverage selection, including online health insurance marketplaces – also known as exchanges.
- Obamacare led to the creation of health insurance marketplaces in every state.
- Thirty-six states have implemented Medicaid expansion in some form, or are in the process of doing so.
- Some states implemented a CO-OP or a Basic Health Plan.
- Millions of exchange enrollees benefited from reduced coverage costs through subsidies.
- Consumer protections included protections for those with pre-existing conditions.
- Obamacare also improved health plan benefits in ACA-compliant plans through the mandated inclusion of essential health benefits.
- Republicans have opposed – and attempted to repeal – the law’s provisions.
- Supporters of the law continue to fight to preserve its provisions.
What is Obamacare?
The Patient Protection and Affordable Care Act – commonly referred to as the Affordable Care Act and also known as Obamacare – is a sweeping piece of legislation passed by the 111th Congress and signed into law by President Barack Obama in 2010.
The law included more than 1,000 pages of provisions intended to make coverage affordable for and accessible to millions of Americans who struggled to pay for individual coverage – many of whom could not buy individual coverage at any price due to pre-existing medical conditions. The law sharply reduced the number of uninsured Americans, although the uninsured rate has started to creep upwards under the Trump administration’s watch.
Obamacare’s key provisions
The Affordable Care Act’s signature provisions included:
- Health insurance exchanges designed to provide a straightforward, affordable way for consumers to compare plans and enroll in qualified coverage on the individual market. See health insurance exchange information for each state.
- Expansion of Medicaid eligibility to cover all adults with incomes below 138% of the federal poverty level. See the Medicaid expansion status of your state and read about the expansion’s impact on states.
- Nonprofit health insurance co-ops that offer ACA-compliant plans in individual and small-business markets — four are still operational in five states — and the Basic Health Plan option for low-income enrollees, which New York and Minnesota implemented.
- Income-based premium subsidies that make ACA-compliant comprehensive coverage affordable for millions. See if you’re eligible for a premium subsidy and calculate your premium subsidy.
- Cost-sharing subsidies that reduce Silver-plan buyers’ out-of-pocket spending.
- Establishment of the Medical Loss Ratio – the 80/20 Rule – which forced health carriers to devote more premium dollars to care of policyholders or issue refunds when premiums were too high.
- Allowing young adults to remain on their parents’ plans until age 26.
- Mandated protections for millions of Americans with pre-existing health conditions.
- A requirement that all individual and small-group health plans include coverage for 10 essential health benefits.
- An end to lifetime maximum benefits on ACA-compliant health insurance policies.
- Mandated coverage — with no out-of-pocket costs — of a long list of preventive services in ACA-compliant plans.
- Numerous provisions designed to reduce Medicare spending, drive down costs and improve coverage for Medicare beneficiaries.
Here’s an extensive list of ways that the Affordable Care Act offered protection and affordable coverage for Americans.
The battle over Obamacare
From the earliest conversations about the Affordable Care Act, the law and its provisions have been vigorously opposed – and sabotaged – by Congressional Republicans.
The opposition has included numerous legal challenges over the ACA’s constitutionality (among them the Texas vs. Azar lawsuit) as well as piecemeal weakening of the law by President Donald Trump’s administration. Consumer advocates note that this sabotage has worsened coverage options and driven premiums upward.
Steve Anderson, healthinsurance.org’s editor and content manager, has been writing about health insurance and health reform since 2008. Steve is also co-founder and editor of medicareresources.org. In previous lives, he worked as a community journalist, public relations manager and director of public affairs.