What does the Affordable Care Act do?
Last fall the U.S. Supreme Court heard arguments in a case brought by 21 states and supported by the Trump administration, challenging the Affordable Care Act (ACA). The lawsuit seeks to void the entire 2010 health reform law, often called “Obamacare,” because Congress eliminated the tax penalty on those without coverage, which was meant to enforce the part of the law’s “individual mandate” to purchase health insurance. In February of this year, the Biden administration — which does not support the lawsuit — officially notified the Supreme Court it views the ACA as constitutional.
If the ACA is invalidated, the result would strip health insurance from millions of people, especially low- and middle-income Americans, those with pre-existing medical conditions, and those lacking employer-provided insurance.
Though the case focuses on the individual mandate, the health reform law, in fact, has always been much more than a mandate or the online marketplaces that have become so familiar to millions of Americans. It’s designed to ensure that everyone can have access to health care, no matter who they are or what their health condition may be – a goal that Blue Cross and Blue Shield companies share. That’s why the Blue Cross Blue Shield Association submitted a friend-of-the-court brief on the case, outlining the benefits of the law.
Most public discussion about the ACA has focused on individuals who purchase coverage on their own, often by using state or federally-run “exchanges” like Healthcare.gov. Many of the law’s most important provisions, like the one that guarantees those with pre-existing conditions can’t be denied coverage or charged more because of their health status, apply to policies purchased by individuals. So is the guarantee of a broad range of essential health benefits, including hospital and emergency care, maternity and newborn coverage, prescription drug benefits and mental health coverage.
These far-reaching changes transformed the individual health insurance market.
Yet, the ACA is a comprehensive law that impacts people no matter how they get coverage—through their employers and through government programs such as Medicare and Medicaid. A broad range of enhanced benefits, strengthened consumer protections and improvements in the way medical care is delivered are all part of the Affordable Care Act.
Here are some key elements of the law: