Affordable Care Act (ACA)

Also known as Obamacare, the ACA is a comprehensive healthcare reform law enacted in 2010 in the United States. It aimed to make healthcare more accessible and affordable for millions of Americans.

 

Health Insurance Marketplace

An online platform where individuals and families can compare and purchase health insurance plans. The ACA established these marketplaces to facilitate easier access to coverage.

 

Individual Mandate

A provision requiring most Americans to have health insurance coverage or face a penalty during tax filing. The individual mandate was designed to encourage a broader and healthier pool of insured individuals.

 

Subsidies

Financial assistance provided by the government to help lower-income individuals and families afford health insurance premiums. Subsidies are a crucial component of the ACA to ensure broader coverage.

 

Medicaid Expansion

A key provision of the ACA that allowed states to expand their Medicaid programs, providing health coverage to more low-income individuals. This aimed to bridge the gap for those who didn’t qualify for traditional Medicaid but couldn’t afford private insurance.

 

Pre-existing Conditions

Health conditions that individuals had before applying for health insurance. The ACA prohibits insurers from denying coverage or charging higher premiums based on pre-existing conditions.

 

Essential Health Benefits

A set of ten categories of health services that insurance plans must cover under the ACA. These include services like preventive care, maternity care, mental health, and prescription drugs, ensuring comprehensive coverage.

 

Healthcare.gov

The official website created by the federal government to facilitate enrollment in health insurance plans through the Health Insurance Marketplace. State-specific marketplaces also exist in some areas.

 

Employer Mandate

A requirement for certain large employers to offer health insurance coverage to their full-time employees. The ACA imposes penalties on employers who do not comply with this mandate.

 

Medical Loss Ratio (MLR)

A provision that requires insurance companies to spend a specified percentage of premium revenue on healthcare services and quality improvement activities rather than administrative costs or profits.

 

Accountable Care Organizations (ACOs)

Groups of healthcare providers who voluntarily come together to coordinate and provide high-quality care to patients. ACOs aim to improve patient outcomes and reduce costs, aligning with the ACA’s goals.

 

Cadillac Tax

A tax on high-cost employer-sponsored health insurance plans, designed to discourage overly generous plans and control healthcare spending.