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What is the Affordable Care Act?

The Affordable Care Act (ACA) is the name of the health care reform law and its amendments, which address health insurance coverage, costs, and preventive care. The Affordable Care Act is often referred to as Obamacare since it was signed into law in March 2010 by President Barack Obama.

Under the ACA, those who were previously uninsured due to preexisting conditions or financial circumstances and those who were insured in high premium plans or limited benefit plans may now be eligible for more affordable health plans with essential benefits. The ACA has given millions of people access to quality health care. ACA-compliant plans cover things like annual checkups, maternity and newborn care, prescription drugs, emergency services, mental health services, pediatric services and more.

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Learn More About the Affordable Care Act

In this video, we explain the ACA and Health Insurance Marketplace, including information about how you can get financial help paying for health insurance, what types of medical services are covered by ACA Marketplace plans and when you can enroll you and your family. 

Who is eligible for ACA plans?

To be eligible to enroll in a Marketplace plan, you must:
  • Live in the United States
  • Be a U.S. citizen, national or lawfully present
  • Not be incarcerated
  • Have income above 100% of the federal poverty level

However, even if you meet the above eligibility criteria, you’re not eligible to get a Marketplace plan if you’re eligible for Medicare or Medicaid coverage.

In addition to U.S. citizens, here are a few categories of immigrants who can enroll in Marketplace coverage:

  • Lawful Permanent Resident (LPR) or Lawful Temporary Resident (LTR)
  • Cuban/Haitian entrant
  • Asylee and Refugee (eligible if they’ve been granted employment authorization or are under the age of 14 and have had an application pending for at least 180 days)
  • Temporary Protected Status (TPS)
  • Work or student visa

To view the full list, click here.

What is the American Rescue Plan?

In 2021, the federal government passed the American Rescue Plan (ARP) to provide COVID-19 relief. In addition to providing stimulus checks, the law also makes ACA plans more affordable by increasing financial assistance and making more people eligible to receive it. As part of the American Rescue Plan, consumers and ACA enrollees may benefit from higher subsidies. Amount of subsidy and savings is based on subsidy eligibility, annual income, age, county and the plan selected.

What does the American Rescue Plan mean for you?

  • If you currently have an ACA plan and qualify for additional financial assistance, you may have a lower monthly cost no later than Sept. 1, 2021. You may also be eligible for health plans with more benefits at a lower cost.

  • If you currently have an ACA plan and qualify for additional financial assistance, you may have a lower monthly cost no later than Sept. 1, 2021. You may also be eligible for health plans with more benefits at a lower cost.

Key dates for getting Marketplace coverage for 2022 during Open Enrollment

  • Nov. 1-Dec. 15: Enroll or renew plans for coverage starting on Jan. 1, 2022
  • Dec. 15-Jan. 15: Enroll or renew plans for coverage starting on Feb. 1, 2022

Keep in mind that you may be eligible to get a health plan outside of the Open Enrollment Period if you qualify for a Special Enrollment Period (SEP). An SEP is caused by a qualifying event, such as having a baby, getting married, or moving to a new county. Also, if your household income is currently less than 150% of the federal poverty level, you’re eligible to enroll anytime during 2022 because of the ARP. Learn more about how and when to enroll in health insurance.

Learn about How and When to Enroll

What are the Four “Metal” Categories?

the four metal categories for plans on the Health Insurance Marketplace (Obamacare) are platinum, gold, silver and bronze

Plans on the Health Insurance Marketplace are presented in four metal categories:

  • Platinum
  • Gold
  • Silver
  • Bronze

All metal plans cover the same set of essential health benefits and do not affect the quality of care you’ll receive. The categories are based on how you and the plan will share the costs for health care services. 

For example:

  • Platinum plans generally have the highest premiums but the lowest costs when receiving care. These plans are a good choice if you need a lot of care and can afford a high monthly premium.
  • Gold plans have a high premium and low costs when receiving care. These plans are a good choice if you need a lot of care.
  • Silver plans have a moderate premium and cost when receiving care. If you qualify for cost-sharing reductions, you must select a Silver plan to get the “extra savings.” These plans are a good choice if you’re willing to pay more for your care to have a lower premium, or if you qualify for extra savings.
  • Bronze plans typically have the lowest premiums but the highest deductibles and other out-of-pocket costs. These plans are a good choice if you want peace-of-mind protection from worst-case medical issues.

Frequently Asked Questions

The government offers financial help to those who qualify to help pay part of the monthly cost of the health plan. Use HealthCare.gov’s Eligibility Estimator to determine your eligibility.

The government reviews information such as:

  • Your household income
  • Your family size and individual ages
  • Where you live

The amount of financial help you get will be based on this information. If you qualify, you'll pay a lower monthly cost for your health plan.

If you have CHIP coverage, you do not need to take any action.

For information on CHIP, call Florida KidCare at 1-888-540-5437 or Florida Healthy Kids at 1-888-540-KIDS (5437).

While ACA did help strengthen Medicare by lowering prescription drug costs and expanding preventive benefits, it does not impact how you apply or receive Medicare. However, ACA Marketplace plans are not Medicare plans and should not be purchased by anyone who qualifies for Medicare. So, ACA does not affect how you apply for Medicare.

To learn more about Medicare, visit our Medicare Education pages.

When a health insurance plan is ACA-compliant, it means that it conforms to the regulations enacted by the Affordable Care Act (Obamacare). These compliant plans must include coverage for ten essential health benefits (EHBs):

  • Emergency services
  • Hospitalization
  • Ambulatory patient services (outpatient care received without being admitted to a hospital)
  • Preventive and wellness services
  • Pediatric services (includes vision and dental care)
  • Prescription drugs
  • Mental health and substance use disorder services
  • Pregnancy, maternity, and newborn care
  • Rehabilitative and habilitative services and devices
  • Lab tests

ACA-compliant plans also have other rules and regulations they must follow and meet, but the specifics can be different depending on the type of health plan.

There is no difference. Obamacare is an informal name used to refer to the Affordable Care Act, since it was signed into law by President Barack Obama.

According to Healthcare.gov, the purpose of the Affordable Care Act was to help more people in the U.S. get health insurance coverage by reducing the cost of coverage for people who qualify for it. As a health care reform act, its goal was to improve the quality of health care and health insurance and to reduce spending related to health care in the U.S. 

Learn More About Health Insurance

  • How to Choose a Plan >

    Ready to take the next step? Explore our guide on how to choose the right plan for you when shopping for health insurance.

* To be eligible for $0 monthly cost, your Marketplace monthly advance premium tax credit must be equal to or more than the premium.

Policies have limitations and exclusions.  The amount of benefits provided depends on the plan selected and the premium may vary with the amount of benefits selected.

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