Our ‘Affordable Care Act’ Summary breaks down ObamaCare section by section. The ‘Affordable Care Act’ summary will give the most factual representation of the law by summarizing each of the Act’s 10 titles. Every title and every section of the ‘Affordable Care Act’ is packed with details (even the condensed version of the law is about 1000 pages long).
Keeping in mind the length of the Patient Protection and Affordable Care Act, we have separated our section-by-section analysis of the law from our basic summary of each title. If you keep reading this page, you will get a basic overview of the law and each title contained within it.
The Patient Protection and Affordable Care Act (PPACA) 2010 HR3590, or Affordable Care Act (ACA) for short, is the new health care reform law in America and is often called by its nickname Obamacare. The Patient Protection and Affordable Care Act is made up of the Affordable Health Care for America Act, the Patient Protection Act, and the healthcare-related sections of the Health Care and Education Reconciliation Act and the Student Aid and Fiscal Responsibility Act. It also includes amendments to other laws like the Food, Drug, and Cosmetics Act and the Health and Public Services Act. Since being signed into law, additional rules and regulations have expanded upon the law. We have attempted to update our summaries with those changes.
The Affordable Care Act is a long, complex piece of legislation that attempts to reform the healthcare system. It provides more Americans with affordable quality health insurance and attempts to curb the growth in healthcare spending in the U.S.
Reforms include new benefits, rights and protections, rules for insurance companies, taxes, tax breaks, funding, spending, the creation of committees, education, new job creation, and more.
Please note that the law gives power to ongoing efforts by Health and Human Services and other Government programs to reform health care in many cases. So healthcare reform doesn’t start and end with the Act itself. Make sure to check out the official HHS site for more information on healthcare reform outside of the ACA.
The Affordable Care Act addresses the following topics in detail – each topic is a title, which contains sections of provisions that reform our health care system:
This Summary of the ACA will help you get an idea of what exactly is in The Affordable Care Act (ObamaCare) and how it applies to you. Having a basic understanding of the law will help you to digest the details below.
The Affordable Care Act helps to reform the healthcare system by giving more Americans access to quality, affordable health insurance, and helps to curb the growth of healthcare spending in the U.S.
While the law itself is confusing to read, most of what the average person thinks of as “ObamaCare” or the ACA is contained within the first title. The first title, Quality Affordable Health Care For All Americans, contains most of the new benefits, rights, and protections. It has new rules for insurance companies and insurance exchanges. It contains rules for mandates, tax credits, cost-sharing reduction subsidies. There are new rules for businesses. The law includes most of the provisions you have heard about except Medicare, Medicaid, new taxes, and a few other programs.
The first title spans about 140 pages and contains a lot of white space, with around 450 characters a page. Luckily our Summary of Provisions of the Patient Protection and Affordable Care Act breaks down those 150 pages into about 5 pages of text.
Do you want to skip the Affordable Care Act Summary and just read the bill? Download the Full Affordable Care Act Bill.
Or check out this detailed ObamaCare Facts Health Care Reform Timeline of every protection, benefit, and a tax laid out by the Affordable Care Act from 2010 to 2022.
The Affordable Care Act is it is broken down into titles; each title is broken down into subtitles; subtitles are broken down into sections that contain provisions or amendments to other laws. Provisions are the parts of the law that affect Americans. Our goal will be to break down each title, subtitle, section, and provision to give you a complete, yet simplified, understanding of exactly what the Affordable Care Act does.
The first two sub-titles of the law contain immediate improvements to the healthcare system. Many of these provisions worked as temporary fixes until the provisions could be fully implemented. The next four subtitles deal with the insurance exchanges, cost assistance, rules for businesses, mandates, and some miscellaneous provisions. Below we discuss where the related provisions stand today.
Provisions of the first title of the Affordable Care Act:
• Eliminate lifetime and unreasonable annual limits on benefits – The law did away with annual and lifetime dollar limits completely by 2014. In the past, over 60% of bankruptcies were medical related, and 3/4 of these bankruptcies happened to those with health insurance, many due to reaching coverage limits.
• Essential Health Benefits must be included on all new plans. Learn about the benefits of Obamacare.
• Prohibit rescissions of health insurance policies – You can no longer be dropped from coverage for any reason aside from fraud. Before the ACA, it was common practice to find a reason such as an honest mistake on an application to drop patients when the cost of their care got too great.
• Provide assistance for those who are uninsured because of a pre-existing condition – temporary high-risk pools were established for people with pre-existing conditions. As of 2014 no one could be charged more or dropped from coverage due to having a pre-existing condition. You can’t be charged more due to your health status either.
• Require coverage of preventive services and immunizations – All health plans starting after 2014 and all non-grandfathered health plans have to provide many A and B rated preventative services at no out-of-pocket cost on all insurance plans. This started in 2014.
• Extend dependent coverage up to age 26 – Dependents can stay on their parent’s plan until 26.
• Develop uniform coverage documents so consumers can make apples-to-apples comparisons when shopping for health insurance – In the past, there was no uniform system for showing benefits included in insurance plans. Today a simple, standardized document makes comparing insurance options easy.
• Cap insurance company non-medical, administrative expenditures – Insurance companies are required to spend 80% of premium dollars on medical costs in small markets and 85% in large group markets. The remaining 20% or 15% can go to administrative costs. If they spent a greater percentage, you are entitled to a rebate.
• Ensure consumers have access to an effective appeals process and provide the consumer with a place to turn for assistance navigating the appeals process and accessing their coverage – In the past, if you were denied treatment or had to make an appeal to your insurance company, you had few rights. Today you have the right to a rapid appeal.
• Create a temporary re-insurance program to support coverage for early retirees – Starting 2014, all Americans can use the health insurance marketplace to purchase coverage.
• Establish an Internet portal to assist Americans in identifying coverage options – healthcare.gov was established to provide accurate information on the law and to provide a portal to the State-based health insurance marketplaces.
• Facilitate administrative simplification to lower health system costs – all medical data is now collected on centralized databases making coordinating care more effective.
• Require individuals to maintain Minimum Essential Coverage (most types of health insurance) starting in 2014.
• Many new rules for businesses improve equality in the workplace in regards to healthcare.
• You can no longer be charged more money based on health status, gender, or salary.
The first title states that the Affordable Care Act puts individuals, families and small business owners in control of their own healthcare.
The Affordable Care Act reduces what most people will pay for health care by capping out of pocket expenses and requiring all preventative care to be fully covered and without cost to the individual.
Nothing in the ACA forces any American to have health care or to drop their current health care plan, assuming that plan complies with the ACA or retains a grandfathered status if signed before the bill became law.
The ACA creates a competitive insurance market now known as the health insurance marketplace. All Americans are able to choose their insurance from these plans. Since everyone has access to the same care through the Affordable Care Act, it helps to ensure that all Americans receive quality health care. Those wishing to purchase private health insurance can do so with all the added benefits and protections of the new law.
All participants in the exchanges pay into the Affordable Care Act; the insurance exchange pools buying power and allow individuals to afford private insurance plans better. These plans have to compete for your business, thus helping to regulate cost and quality.
Small business owners can purchase coverage, and can receive tax credits for up to 50% of the cost of their employee’s health insurance making it easier to give their employees benefits.
The Affordable Care Act keeps insurance companies honest by setting clear rules that rein in the worst insurance industry abuses. And it bans insurance companies from denying insurance coverage because of a person’s pre-existing medical conditions while giving consumers a new power to appeal insurance company decisions that deny doctor ordered treatments covered by insurance.
Some aspects of the law that went into effect starting in 2010: American families and small business owners have begun to experience the benefits of this common-sense reform:
The Affordable Care Act extends Medicaid, preserves CHIP (a successful children’s insurance plan) and simplifies enrollment.
It improves community-based care for disabled Americans and provides States the opportunity to expand home care services for people with long-term care needs.
The Act treats all States equally and gives them the flexibility to adopt strategies to improve care in coordination with Medicare and Medicaid beneficiaries.
The Affordable Care Act TITLE II states that it saves the taxpayer money by reducing prescription drug costs and payments to subsidize care for uninsured Americans.
The Act also gives more Americans access to health insurance greatly increasing the number of Americans who have health care.
The Affordable Care Act preserves, protects, and reforms Medicare.
The ACT closes the coverage gap “donut hole” for drug costs for seniors. Seniors will save thousands of dollars in drug costs due to closing the “donut hole.”
Healthcare institutions and professionals will be incentivized to improve care.
The Affordable Care Act provides additional health services to rural America.
The Act ends the overpayment of tens of billions of dollars to insurance companies to help protect Medicare.
Taxpayer dollars are saved by keeping people healthier before joining Medicare, reducing Medicare’s need to pay hospitals to care for uninsured patients.
A team of healthcare experts, and not members of Congress, will work together to come up with the best ideas to keep Medicare running by figuring out how to improve the quality of coverage and reduce costs for Medicare.
Medicare is a sacrosanct trust with America’s seniors, and this Act preserves it.
Title IV promotes prevention, wellness, and public health via unprecedented funding.
The Act uses national prevention and health promotion strategies to work to improve the health of Americans and reduce preventable illness and disability to keep Americans healthy and keep health care costs down.
It will make nutritional information more available.
Co-payments will be waived for preventative measures for seniors.
The law adds many preventative services for women.
The law as a whole will save taxpayers by ensuring that people have access to the preventative measures saving millions of lives and reigning in astronomical hospital bills that go unpaid and drive up the cost of healthcare.
If we want to benefit American families by reforming health care, we need to transition from a system focused primarily on treating the sick to one that helps keep people remain well throughout their lives.
The Act will promote prevention, wellness, and the public health and provides an unprecedented funding commitment to these areas. It directs the creation of a national prevention and health promotion strategy that incorporates the most effective and achievable methods to improve the health status of Americans and reduce the incidence of preventable illness and disability in the United States.
The Act relies on the innovation of small businesses and state and local governments to find the best ways to improve wellness in the workplace and our communities. And it strengthens America’s capacity to respond to public health emergencies.
The Act empowers families by giving them tools to find the best science-based nutrition information, and it makes prevention and screenings a priority by waiving co-payments for America’s seniors on Medicare.
By attacking disease before it hits, the Act helps to improve health, save lives, and avoid more costly complications down the road.
The Affordable Health Care Act funds scholarships and loan repayment programs to assist young people with going to school for healthcare-related professions.
The act promotes much-needed jobs in the healthcare industry to prepare for our future thus creating jobs for American workers.
The Act gives states the power to recruit healthcare workers.
It helps fund and expands community health centers.
Because doctors, nurses, and other healthcare providers are the backbone of the health care system, the Act supports and expands our Nation’s health care workforce.
The Affordable Care Act focuses on keeping Americans informed about healthcare.
It attempts to strengthen doctor-patient relationships using new medical research and access to more data to allow doctors and patients to make the decisions that work best for them.
It provides greater transparency in nursing homes by placing regulations and incentive programs to help improve quality control.
The Act reins in waste, fraud, and abuse by imposing disclosure requirements to identify high-risk providers who have defrauded the American taxpayer.
States now have the authority to prevent providers who have been penalized in one state from setting up in another.
It gives states flexibility to propose and test tort reforms that affect patient safety, encourage resolution of disputes and improve liability insurance.
Extending Discounts on Drugs
Promoting Medication Price Competition and Innovation
The Act promotes innovation and saves consumers money. It attempts to end anti-competitive behavior by drug companies that keep effective and affordable generic drugs off the market. It extends drug discounts to hospitals and communities that serve low-income patients. And it creates a pathway for the creation of generic versions of biological drugs so that doctors and patients have access to effective and lower cost alternatives.
Title VIII establishes a Voluntary, Self-Funding Long-Term Insurance Choice for American Families
The Act provides Americans with a new option to finance long-term services and care in the event of a disability.
There is a self-funded and voluntary long-term care insurance choice. Workers will pay in premiums to receive a daily cash benefit if they develop a disability. Need will be based on difficulty in performing basic activities such as bathing or dressing. The benefit is flexible; it could be used for a range of community support services, from respite care to home care.
No taxpayer funds will be used to pay benefits under this provision. The program was designed to reduce Medicaid spending, as people could continue working and living in their homes and not enter nursing homes. Safeguards were intended to be put in place to ensure its premiums were sufficient to cover costs.
The CLASS Act was repealed on January 1, 2013.
Improved Enforcement and Closing Tax Loopholes
Broadened Medicare Hospital Insurance (HI) Tax Base for High-Income Taxpayers
Reformed Excise Tax on Insurance Companies
Health Industry Fees
Additional Health Savings
Additional Tax Benefits for Healthcare
The Affordable Care Act made health care more affordable for families and small business owners and raised taxes on high earners, large businesses, and the health care industry. It also limited medical deductions. Tens of millions of families have benefited from new tax credits which helped them reduce their premium costs and purchase insurance. American families making less than $250,000 as a group will saw their taxes cut by hundreds of billions of dollars.
When fully enacted, health reform is expected to be completely paid for and will reduce the deficit by more than one hundred billion dollars in the next ten years.
The Act reauthorizes the Indian Health Care Improvement Act (ICHIA) which provides health care services to Native Americans and Alaskan Natives. It will modernize the tribal health care system and improve health care for 1.9 million Native Americans and Alaska Natives.
Thanks for checking out our Affordable Care Act Summary. Please help us to spread the facts by sharing our Affordable Care Act Summary and some Affordable Care Act facts with your friends and neighbors. If you would like more in-depth information on each title, don’t forget to check out our Summary of Provisions of the Patient Protection and Affordable Care Act.
Affordable Care Act Summary Title by Title
Thomas DeMichele is the head writer and founder of ObamaCareFacts.com, FactsOnMedicare.com, and other websites. He has been in the health insurance and healthcare information field since 2012. ObamaCareFacts.com is a.
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