Eleven million Americans, including 180,000 Arizonans, signed up for health insurance thought the government-run individual marketplaces created through the Affordable Care Act in 2016. Most qualified for federal subsidies to help pay for those private plans.
A majority of Americans get their health insurance through their employer or a government program, and a minority need to buy it through the individual marketplace, which is sometimes also called a health exchange.
But the law, passed in 2010, has other provisions that gave coverage and insurance protections to millions more Americans, including:
- Keeping young adults on their parents health insurance until they turn 26.
In Arizona, an estimated 60,000 young adults under the age of 26 gained coverage by staying on their parents plans, says an analysis by the Arizona Alliance for Community Health Centers. Nationally that number is 2.3 million, the U.S. Department of Health and Human Services says.
- In conjunction with the Affordable Care Act, several states including Arizona expanded their Medicaid programs. Arizona both expanded its Medicaid program and restored coverage for childless adults. The Medicaid expansion has resulted in 81,116 Arizonans getting coverage, and 316,763 childless adults have signed up since 2014.
- Elimination of lifetime and annual limits on coverage.
- Before the law, people who needed expensive and unexpected health care for cancer, for example, could find out their plan would only pay up to a certain amount, like for instance $300,000.
- The consumer would then be on the hook to pay for the rest, sometimes hundreds of thousands of dollars.
- Eliminating of pre-existing condition exclusions for coverage.
- Insurers can no longer reject people because of past health conditions.
- Insurers cannot charge women more than men.
- Private health insurance plans generally must provide coverage for an additional set of preventive health services for women without cost-sharing requirements.
- The medical loss ratio provisions in the Affordable Care Act limit the amount of premium dollars insurers can spend on administration, marketing, and profits.
