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Affordable Care Act 2010

AQA, Edexcel, OCR, IB, Eduqas, WJEC

Last updated 22 Mar 2021

The Patient Protection and Affordable Care Act of 2010, often known as the ACA or Obamacare is federal law in the United States which requires all citizens of the US to purchase health insurance. The main aims of the act are to lower the number of uninsured Americans and increasing the quality and affordability of health insurance.

Main provisions of the Act:

  • Insurers must offer health insurance to all citizens regardless of pre-existing medical conditions or gender. This must be the same in all geographical locations.
  • Minimum standards for all health insurance policies provided by insurers
  • Individual mandate (requirement) for all citizens who are not currently covered under an employer, state or Medicaid/Medicare programme must buy health insurance. Subsidies are available for those people on low incomes to help them afford health insurance. Anyone who has not purchased health insurance is liable for a financial penalty.
  • Creation of Heath Insurance Exchanges were consumers can purchase health insurance and compare options and prices
  • Small businesses are eligible for federal subsidies to help them provide health insurance to employees
  • Expansion and increased efficiency of Medicare
  • Children can remain on their parent’s health insurance policy until they are 26
  • Insurers can no longer suspend policies when policyholders get sick
  • Insurers can no longer impose limits on the total cost of treatment
  • All policies must contain preventive care and medical screening

Federal Healthcare reform in the US has been a long and slow process with a number of attempts being made into introduce some form of universal coverage. Bill Clinton famously tried to introduce healthcare but the bill he proposed died in committee.

The Affordable Care Act was introduced in 2009 to Congress and has an interesting legislative process. Numerous obstacles presented themselves to the bill including rival bills from the House of Representative and Senate, changes in the electoral make up of the Senate making filibusters far more likely and a huge amount of compromises and deals to bring the ACA to life. The Senate passed the Patient Protection and Affordable Care Act on Christmas Eve 2009, and waited for the House to pass the same bill. House Democrats were unsure about the Senate version of the bill, but due to the requirement of differing bills to be reconciled in committee and a new vote and that new bill potentially being filibustered in the Senate, House Democrats passed the bill on 21 March 2010. The only caveat to the bill passing was the addition of the Health Care and Educational Reconciliation Act which amended the ACA slightly. This Act was passed on the 21st March 2010.

President Obama signed the Affordable Care Act into law on March 23rd and ever since Republican law makers have tried to repeal the act through various pieces of legislation.

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