Difference Between ACA and Obamacare

What’s the Difference Between the Affordable Care Act and Obamacare?

Although you’ve likely heard of Obamacare, you may not know that Obamacare is synonymous with the Affordable Care Act. This healthcare law that passed in 2010 goes by a few different names. You may also see this law referenced as PPACA or ACA (the acronym for Affordable Care Act).

Below, let’s discuss what Obamacare or the ACA covers, its goals, when you can enroll, and more.

Learn more about Affordable Benefits, talk with one of our team members!

What Do Obamacare and the Affordable Care Act (ACA) Cover?

The Affordable Care Act was designed with three primary goals. To:

“Make affordable health insurance available to more people…
Expand the Medicaid program to cover all adults with income below 138% of the FPL
Support innovative medical care delivery methods designed to lower the costs of health care generally.”

Additionally, there are sections of the ACA designed to help patients have access to affordable benefits. These sections include:

Quality, Affordable Healthcare for All Americans
The Role of Public Programs
Improving the Quality and Efficiency of Healthcare
Prevention of Chronic Disease and Improving Public Health
The Difference Between the ACA and Obamacare
Healthcare Workforce
Transparency and Program Integrity
Improving Access to Innovative Medical Therapies
Community Living and Assistance Services and Supports Act (CLASS Act)
Revenue Provisions
Reauthorization of the Indian Healthcare Improvement Act

From these sections came the 10 essential benefits that are included in minimum essential coverage (MEC), which is defined as “any insurance plan that meets the Affordable Care Act requirement for having health coverage.”

These 10 benefits include:

Prescription drug coverage
Pediatric services
Preventative, wellness services, and chronic disease management
Emergency services
Hospital-stay coverage
Mental health and addiction services
Pregnancy, maternity, and newborn care
Ambulance patient services
Laboratory services
Rehabilitative and habilitative services and devices

SBMA The Affordable Care Act (ACA) vs. Obamacare What’s the Difference

Why Was This Healthcare Law Created?

Obamacare was designed to provide basic and affordable coverage for all Americans. Before Obamacare, those with pre-existing conditions could be refused coverage or charged more for their plan.

Obamacare ensures that insurance companies allow those with pre-existing conditions to receive the same care as those without.

Now, minimum essential coverage plans exist that provide the services required by the ACA while simultaneously being affordable for employers and employees.

These plans help both parties stay healthy while also avoiding the fines and penalties that come along with not having health insurance (especially for Americans living in states with individual mandates).

After all, minimum essential coverage isn’t a one size fits all service. There are different options and levels to choose from to create a plan best suited for your specific needs.

Learn more by reading our article, “What is MEC and What Does It Cover?”

When Can I Enroll in Obamacare?

Open enrollment is the one time of the year when employees can sign up for health insurance or change their health insurance plans.

If you choose not to enroll during the open enrollment period, your options to purchase coverage become limited. Why? You cannot purchase ACA-compliant coverage unless a qualifying event occurs.

Qualifying events include:

Loss of a job
Move to a new coverage area
Birth of a child
Loss of existing coverage
Family event (i.e. marriage, divorce, or death)

Depending on state requirements, employees can take advantage of open enrollment for the following year starting November 1 until approximately January 15th. Again, open enrollment varies on a state-by-state basis. States like California, for example, extend their open enrollment dates to January 31.

Read on to learn what happens if your employee misses open enrollment.

How does the Individual Mandate Affect Obamacare?

When Obamacare was first implemented, it contained a clause that required Americans to have health insurance. Those who didn’t have health insurance were required to pay a tax penalty. This tax penalty was repealed in 2017.

However, the individual mandate is still in effect for some states in the U.S.

Residents living in the following states have implemented individual mandates.

California
The District of Columbia
Massachusetts
New Jersey
Vermont
Rhode Island

This means that people living in the states mentioned above must have health insurance or face state-mandated tax penalties. Read on to learn more about ACA employer penalties.

At SBMA, our goal is to provide affordable ADA-compliant benefits to our clients. For more information about the plans that we offer or to enroll, get in touch with one of our brokers today.