We the Patients

Benefits of the Affordable Care Act

How did the ACA make care more affordable?

How did the ACA make care more affordable?

The ACA made health insurance more affordable in three ways. First, it requires most people to have coverage; the more people who band together to buy coverage, the cheaper it becomes for everyone.

Second, it provides financial assistance for people to be able to buy commercial coverage if they don’t get coverage through their job. It also expanded the income limits for Medicaid (the program for poor people), so more people are able to access free coverage and lets states like New York to offer the Essential Plan, a comprehensive health program that has no deductibles and very low or free premiums.

Third, the ACA sets uniform rules for insurance policies. Here are just a few examples:

  • The ACA limits your out of pocket costs,
  • The ACA defines what are the essential benefits a plan must cover and how an insurance policy can much people.
  • The ACA requires insurance companies to spend at least 80% of your premium dollar on health care costs, not profits and administration.
  • The ACA reduces prescription drugs costs for people with Medicare coverage.

How did it make care more accessible?

The ACA makes health coverage more uniform and easier for consumers to use. Here are some examples of how it does this. First, the ACA made preventative care free.. Why is preventative care so important? Preventative care is things like mammograms, colonoscopies and chronic disease management — care that keeps you healthy or prevents you from getting sicker.

Second, the ACA eliminated “lifetime” and “annual” limits, or caps on how much care you could get.

The ACA requires your insurance plan to cover a standard list of benefits —called Essential Health Benefits– for the first time! Before, insurance plans did not have to cover important benefits like prescription drugs, maternity care or mental health treatments. Now all plans must cover a lists of ten Essential Health Benefits.

The most important thing it did, though? Making sure people with preexisting conditions still get coverage! That alone helps millions of patients every year who have health problems but need insurance. If it didn’t help people with preexisting conditions, almost half of all Americans could struggle to get the medical help they needed.

How did it make care more useful?

Lastly, the ACA made care more useful. Now that more people get preventative care, the ACA saves lives every day. When a health problem is caught early, it’s easier to treat! And even as COVID-19 strains our healthcare system, more New Yorkers than ever before are able to access care. It even funds scholarships to increase the number of health providers, especially in rural areas. By creating a national strategy to slow cost increases, train more health providers, and promote record sharing, the ACA made our health dollars go further. New York has made incredible progress towards building a healthier state with the ACA. It’s important to know how it works, how it helps, and what it does every day.

If you need to access care, there’s still time! Enrollment is still open at nystateofhealth.ny.gov. If you need care, start there! Community Health Advocates will also help you get the care you need, if you need help!