Go to top of page
Selected Components of the Affordable Care Act
○ Requires uniform premium, regardless of sex or pre-existing conditions.
○ In absence of employer health plan, Medicaid, Medicare: buy insurance or pay penalty.
○ Offers a marketplace for comparison and purchase of insurance policies.
○ Low income individuals and families (1–4× poverty level) to receive federal subsidies.
○ Eligibility to include all individuals and families up to 1.38× poverty level. (States can opt out.)
○ Established for all policies, with ban of coverage caps. Children covered to age 26 years.
○ Firms with ≥50 employees not offering coverage will share subsidy burden.
○ If they purchase insurance through an exchange.
○ Eliminated for benefits considered preventive care.
○ Transitions Medicare reimbursement away from fee-for-service toward value-based and bundled payments. Creation of accountable care organizations