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 of each title contained within.
You can also check out our section-by-section Summary of Provisions of the Patient Protection and Affordable Care Act, or even read the full text of the Patient Protection and Affordable Care Act.
What is the Affordable Care Act?
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 nick-name 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 health care related sections of the 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 singed into law additional rules and regulations have expanded upon the law, we have attempted to update our summaries with those changes.
What Does the Affordable Care Act Do?
The Affordable Care Act is a long, complex piece of legislation that attempts to reform the healthcare system by providing more Americans with affordable quality health insurance and by curbing 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, in many cases, gives power to ongoing efforts by Health and Human Services and other Government programs to reform health care. 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.
Titles of the Affordable Care Act
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.
Title I Quality, affordable health care for all Americans
Title II The role of public programs
Title III Improving the quality and efficiency of health care
Title IV Preventing chronic disease and improving public health
Title V Health care workforce
Title VI Transparency and program integrity
Title VII Improving access to innovative medical therapies
Title VIII Community living assistance services and supports
Title IX Revenue provisions
Title X Reauthorization of the Indian Health Care Improvement Act
Affordable Care Act Overview
This Summary of the ACA will help you get a quick 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.
- All Americans with health insurance will have access to a number of new benefits, rights, and protections which ensure that they can get treatment when they need it, protecting consumers from some of the worse abuses of the health care and insurance industries.
- It makes insurance more affordable by reducing premium and out-of-pocket costs for tens of millions of families and small business owners who had been priced out of coverage in the past. This helps over 32 million Americans afford health care who could not get it before – and makes coverage more affordable for many more. Under the plan, 95% of Americans will be insured. In 2013 over 15% of Americans are without insurance.
- The law spreads risk equally to all insured to end discrimination. In the past you could be discriminated based on gender or health status, or costs could differ wildly due to factors like age. The ACA limits discrepancies in what you can be charged and in order to do this requires all Americans who can afford to maintain Minimum Essential Coverage starting in 2014. Many who can’t afford coverage will be exempt from the requirement to maintain coverage.
- It sets up a new competitive health insurance marketplace (healthcare.gov) giving tens of millions of Americans access to group buying power and allowing them to compare plans and receive cost assistance.
- It puts our budget and economy on a more stable path by reducing the deficit by more than $100 billion over the next ten years – and more than $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.
Understanding the ACA Isn’t As Hard As You Think
While the law itself is a difficult read, most of what the average person thinks of as “ObamaCare” 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, new rules for insurance companies, insurance exchanges, mandates, rules for tax credits and cost-sharing reduction subsidies, new rules for businesses, and just about everything else will hear about with the exception of Medicare, Medicaid, new taxes, and a “few” other details.
The first title spans about 140 pages and contains mostly 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.
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 tax laid out by the Affordable Care Act from 2010 to 2022.
Affordable Care Act Summary of Titles and Provisions
The Affordable Care Act is it is broken down into titles, each title is broken down into subtitles, and 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.
TITLE I – QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS
Subtitle A—Immediate Improvements in Health Care Coverage for All Americans
Subtitle B—Immediate Actions to Preserve and Expand Coverage
Subtitle C—Quality Health Insurance Coverage for All Americans
Subtitle D—Available Coverage Choices for All Americans
Subtitle E—Affordable Coverage Choices for All Americans
Subtitle G—Miscellaneous Provisions
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 misc. provisions. Below we discuss where the related provisions stand today.
Provisions from the first title of the Affordable Care Act:
• Eliminate lifetime and unreasonable annual limits on benefits – The law does 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 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 can be charged more or dropped from coverage due to being a pre-existing condition. You can’t be charged more due to health status either.
• Require coverage of preventive services and immunizations – All health plans starting after 2014 and all non-grandfathered health plans will have to provide many A and B rated preventative services at no out-of-pocket cost on all insurance plans starting 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 can’t spend more than 80% of premium dollars on non-medical costs. If they do, you get a rebate. (85% in large group markets).
• Ensure consumers have access to an effective appeals process and provide consumer 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 little 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 maintain Minimum Essential Coverage (most types of health insurance) starting in 2014.
• Starting 2015 small businesses have to insure full-time workers.
• 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 also reduces what most people will pay for healthcare by capping out of pocket expenses and requiring all preventative care to be fully-covered and without cost to the individual.
Nothing in the Bill forces any American to have healthcare or to drop their current healthcare plan, assuming that plan complies with the ACA or retains a grandfathered status if signed before the bill became law.
There will be a competitive insurance market (now known as the health insurance marketplace) and all Americans will be able to choose their insurance out of these plans. Since everyone will have access to the same care through the Affordable Care Act it helps to ensure that all Americans receive quality healthcare. Those wishing to purchase private health insurance will be able to do so and receive the same care available today.
All participants in the exchanges will be paying into the Affordable Care Act, the insurance exchange will then pool buying power allowing individuals to afford private insurance plans. These plans will have to compete for your business, thus helping to regulate cost and quality.
Small business owners will be able to purchase their own coverage, and will receive tax credits for up to 50% of the cost of their employees health insurance making it easier to give their employees benefits.
It 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 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 will begin to experience the benefits of this common-sense reform:
- New Affordable Choices:
- Uninsured Americans with pre-existing conditions will finally have the choice of quality, affordable insurance through a new insurance pool;
- Small business owners will be eligible for billions in tax credits to help offer insurance coverage to employees;
- New plans will have to offer preventive care and immunizations at no cost;
- New plans and certain existing plans that offer dependent coverage will have to cover an enrollee’s dependent children until age 26;
- A re-insurance program for employers that offer health insurance to their early retirees will save as much as $1,200 for every family enrolled.
- More Power for Consumers:
- A new website to help consumers compare different insurance coverage options along with state-by-state health care consumer assistance and ombudsman for any of their health insurance questions;
- A new independent appeals process for new plans so consumers and patients can appeal insurance company decisions.
- Insurance Company Accountability:
- Prohibits new plans and existing group health plans from denying coverage for children because of a pre-existing medical condition;
- Review of requested insurance premium increases; health insurers with a pattern of excessive rate increases can be blocked from selling through new insurance exchanges;
- Remove arbitrary lifetime limits on coverage in all plans, and remove restrictive annual limits on benefits in all new plans and existing group health plans so people know that all of the care they need will be paid for;
- Prevent insurance companies from dropping insurance coverage when a person gets sick and needs it most.
TITLE II – The Role of Public Programs
The Affordable Care Act extends Medicaid, preserves CHIP (Successful children’s insurance plan) and simplifies enrollment.
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 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 healthcare.
Title III. Improving the Quality and Efficiency of 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 in order 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 patents.
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 sacred trust with America’s seniors, and this Act preserves it.
Title IV. Prevention of Chronic Disease and Improving Public Health
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 in an effort to keep Americans healthy and health care costs down.
Nutritional information will be more prevalent.
Co-payments will be waved 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 astronomical hospital bills that go unpaid and drive up the cost of healthcare.
If we want to truly reform health care to benefit American families, we need to transition from a system focused primarily on treating the sick to one that helps keep people 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 in 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.
Title V Health Care Workforce
Affordable Health Care Act funds scholarships and loan repayment programs to assist young people with going to school for health care 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 power to recruit healthcare workers.
Helps fund and expand community health centers.
Because doctors, nurses, and other health care providers are the backbone of the health care system, the Act supports and expands our Nation’s health care workforce.
Title VI. Transparency and Program Integrity
The Affordable Care Act focuses on keeping Americans informed about healthcare.
Doctor-patient relationships are strengthened via cutting edge medical research and access to more data to allow doctors and patients to make the decisions that work best for them.
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.
Gives states flexibility to propose and test tort reforms that affect patient safety, encourage resolution of disputes and improve liability insurance.
Title VII. Improving Access to Innovative Medical Therapies
Extending Discounts on Drugs
Promoting Biologics Price Competition and Innovation
The Act promotes innovation and saves consumers money. It ends 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. Community Living Assistance Services and Supports Act (CLASS Act)
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.
It is a self-funded and voluntary long-term care insurance choice. Workers will pay in premiums in order 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 will actually reduce Medicaid spending, as people are able to continue working and living in their homes and not enter nursing homes. Safeguards will be put in place to ensure its premiums are enough to cover its costs.
The CLASS Act was repealed January 1, 2013.
Title IX. Revenue Provisions
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 not only makes health care more affordable for families and small business owners and raises taxes on high earners, large businesses, and the health care industry. It also limits medical deductions which is something that some Americans may be affected by. Tens of millions of families will benefit from new tax credits which will help them reduce their premium costs and purchase insurance. Families making less than $250,000 will see their taxes cut by hundreds of billions of dollars.
When enacted, health reform is completely paid for and will reduce the deficit by more than one hundred billion dollars in the next ten years.
Title X. Reauthorization of the Indian Health Care Improvement Act
The Act reauthorizes the Indian Health Care Improvement Act (ICHIA) which provides health care services to American Indians and Alaskan Natives. It will modernize the Indian health care system and improve health care for 1.9 million American Indians 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