• (888) 505-7724
  • updates@sbmamec.com
  • Employer Portal
  • Employee Portal
SBMA Benefits
  • Facebook
  • Instagram
  • LinkedIn
  • Mail
  • Services
  • Benefit Plans
  • Employees
  • Employers
  • Resources
    • Compliance Updates
    • No Surprises Act Resource Page
    • SmithRx Formulary
    • COBRA
  • News & Insights
  • Contact SBMA
  • Search
  • Menu Menu

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).

Table of Contents

  • What’s the Difference Between the Affordable Care Act and Obamacare?
  • What Do Obamacare and the Affordable Care Act (ACA) Cover?
  • Why Was This Healthcare Law Created?
  • When Can I Enroll in Obamacare?
  • How does the Individual Mandate Affect Obamacare?

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
infographics

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.

Search

Categories

LATEST NEWS IN ACA COMPLIANCE

  • ACA Reporting Deadlines and Compliance Requirements in 2023March 19, 2023 - 10:38 am
  • brokers explaining ACA FAQsFAQs: ACA and ALEs – What You Need to KnowMarch 5, 2023 - 9:00 am
  • Full-Time vs Part-Time Benefits:Full-Time vs Part-Time Benefits: Why It MattersJanuary 1, 2023 - 7:00 am

Archive

CONNECT WITH US

USEFUL LINKS

EMPLOYER PORTAL
EMPLOYEE PORTAL
PRIVACY POLICY 
THE BLOG

CONTACT SBMA

888-505-7724
UPDATES@SBMAMEC.COM

HOURS

Mon – Fri: 7:00am—5:00pm (PST)
Sat: CLOSED
Sun: CLOSED

FOLLOW US

© SBMA 2022 – all rights reserved

site designed by digitalstoryteller.io

© SBMA 2021 – all rights reserved
site designed by digitalstoryteller.io

Transamerica and SBMA to the Rescue!Transamerica and SBMA to the Rescue!How Does Telehealth Keep Insurance Costs Down?How Does Telehealth Keep Insurance Costs Down? Scroll to top

This site uses cookies. By continuing to browse the site, you are agreeing to our use of cookies.

Accept settings

Cookie and Privacy Settings



How we use cookies

We may request cookies to be set on your device. We use cookies to let us know when you visit our websites, how you interact with us, to enrich your user experience, and to customize your relationship with our website.

Click on the different category headings to find out more. You can also change some of your preferences. Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer.

Essential Website Cookies

These cookies are strictly necessary to provide you with services available through our website and to use some of its features.

Because these cookies are strictly necessary to deliver the website, refusing them will have impact how our site functions. You always can block or delete cookies by changing your browser settings and force blocking all cookies on this website. But this will always prompt you to accept/refuse cookies when revisiting our site.

We fully respect if you want to refuse cookies but to avoid asking you again and again kindly allow us to store a cookie for that. You are free to opt out any time or opt in for other cookies to get a better experience. If you refuse cookies we will remove all set cookies in our domain.

We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. Due to security reasons we are not able to show or modify cookies from other domains. You can check these in your browser security settings.

Google Analytics Cookies

These cookies collect information that is used either in aggregate form to help us understand how our website is being used or how effective our marketing campaigns are, or to help us customize our website and application for you in order to enhance your experience.

If you do not want that we track your visit to our site you can disable tracking in your browser here:

Other external services

We also use different external services like Google Webfonts, Google Maps, and external Video providers. Since these providers may collect personal data like your IP address we allow you to block them here. Please be aware that this might heavily reduce the functionality and appearance of our site. Changes will take effect once you reload the page.

Google Webfont Settings:

Google Map Settings:

Google reCaptcha Settings:

Vimeo and Youtube video embeds:

Other cookies

The following cookies are also needed - You can choose if you want to allow them:

Privacy Policy

You can read about our cookies and privacy settings in detail on our Privacy Policy Page.

Accept settings