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Marketplace (Obamacare)

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Affordable Care Act (ACA)

The comprehensive health care reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”).

The law has 3 primary goals:

  1. Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level.
  2. Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level. (Not all states have expanded their Medicaid programs.)
  3. Support innovative medical care delivery methods designed to lower the costs of health care generally.

Open vs. Special Enrollment

The yearly period when people can enroll in a health insurance plan is called Open Enrollment (November 1st - December 15th).

You may still be able to enroll in a Marketplace health insurance plan for 2020 if you qualify for a Special Enrollment Period.

You’re eligible if you have certain life events, like getting married, having a baby, or losing other health coverage.

Coverage for pre-existing conditions

All Marketplace plans must cover treatment for pre-existing medical conditions.

  • No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started.
  • Once you’re enrolled, the plan can’t deny you coverage or raise your rates based only on your health.
  • Medicaid and the Children's Health Insurance Program (CHIP) also can't refuse to cover you or charge you more because of your pre-existing condition.