Expanding Health Insurance Coverage

Expanding Health Insurance Coverage Under the Affordable Care Act (ACA)

The **Affordable Care Act (ACA)** significantly expanded health insurance coverage in the United States through several key measures:  

1. Individual Mandate (Later Repealed in 2017)
- Required most Americans to have health insurance or face a penalty.  
- Encouraged broader participation in the insurance market to keep costs lower.  

2. Medicaid Expansion
- Expanded Medicaid eligibility to individuals and families with incomes up to **138% of the Federal Poverty Level (FPL)**.  
- Made it easier for low-income individuals to access healthcare.  
- Initially required all states to expand Medicaid, but a 2012 Supreme Court ruling made it optional. As a result, some states did not adopt the expansion.  

3. Health Insurance Marketplace (Exchanges)
- Created state and federal **health insurance marketplaces** where individuals could compare and purchase insurance plans.  
- Provided **subsidies (premium tax credits)** to lower-income individuals and families, making insurance more affordable.  
- Established cost-sharing reductions to help lower **out-of-pocket expenses** like copays and deductibles.  

4. Employer Mandate
- Required **large employers** (50+ full-time employees) to offer affordable health insurance to employees or face penalties.  
- Helped increase employer-sponsored insurance coverage.  

5. Coverage for Young Adults
- Allowed young adults to stay on their parents’ insurance plans until **age 26**.  
- Helped cover millions of previously uninsured young individuals.  

6. Protections for People with Pre-existing Conditions
- Prohibited insurance companies from **denying coverage** or charging higher premiums based on pre-existing conditions.  
- Ensured that individuals with chronic illnesses could obtain and maintain health insurance.  

These measures significantly reduced the **uninsured rate** in the U.S., particularly among low-income individuals, young adults, and people with pre-existing conditions.