What is the Affordable Care Act?
Signed into law on March 23rd, 2010, The Patient Protection and Affordable Care Act (ACA) is also known as healthcare reform. Healthcare reform is not health insurance. Healthcare reform is law that makes changes to the insurance system. These changes help many more people get health coverage. They also protect consumers more than ever before.
The California Department of Insurance (CDI) regulates insurance in California - including health insurance. We continue to work hard to put these reforms in place. Our goal is to protect consumers, foster the insurance marketplace so that it is vibrant and stable, and enforce the law fairly and impartially.
How does health care reform affect me?
If you have health insurance, you probably have already seen some of the changes in your policy. For example, most policies now let you keep your children on your insurance until age 26. Insurers cannot deny you coverage because if you have an existing health condition. And most policies now provide preventative services, such as immunizations, birth control, mammographies and many other cancer screenings, with no out-of-pocket cost to you. Here are more changes:
- If you get sick, an insurance company cannot cancel your policy.
- Health insurance companies cannot turn down your application because of your health status.
- Women can no longer be charged more for insurance than men. In fact, insurance rates cannot be based on gender or gender identity at all.
- Once you buy health insurance, you do not have to pay anything for preventive care.
- Most coverage must now include Essential Health Benefits (EHBs).
- No more annual dollar limits on coverage for EHBs.
- No more lifetime limits on EHBs.
- Insurance companies have to spend at least 80% of your premium dollars on actual medical expenses, not overhead and profit.
- Medi-Cal will cover more low-income individuals and families (all individuals under 138% of the federal poverty level are eligible).
- Covered California, the marketplace where consumers can shop for and buy health coverage from health insurers, is now operating.
- Subsidies are available to help people pay for their health insurance coverage. Visit Covered California to find out if you qualify.
If you do not have coverage
Healthcare reform makes health coverage available and more affordable for millions of Americans. It gives subsidies for those who purchase private insurance and California expanded Medi-Cal to include more people and single adults. Together with the opening of Covered California's online marketplace, it is easier than ever to get health care coverage. Please see our Getting Health Coverage section for more information about your options.
If someone who can afford coverage does not purchase it, they may have to pay a tax penalty. This is called the shared responsibility payment and sometimes also called the "individual mandate." Some people may qualify for an exemption, but you can find more details about this by visiting Healthcare.gov.
