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  • Hey, everybody.

  • It's me, Ben.

  • And today's question is specific to the United States.

  • How does the Affordable Care Act work, and what does it do?

  • Although its full name is the Patient Protection

  • and Affordable Care Act, you've probably

  • heard it just called the Affordable Care

  • Act, or Obamacare, or the ACA.

  • It's called Obamacare because President Barack Obama signed

  • it into law on March 23, 2010.

  • But what does it actually do?

  • Let's look at the basics.

  • Health care in the United States has some serious long term

  • issues.

  • First, there are millions of uninsured people.

  • Second, people who do have insurance

  • tend to pay more for it than they

  • would in other comparable countries.

  • The ACA aims to fix these issues by making affordable health

  • care available to more Americans.

  • I mean, that's a good idea, right?

  • To do this, the act makes some pretty big changes.

  • But although the act make some big changes to insurance,

  • these changes phase in over time instead

  • of happening all at once.

  • A lot of things will also stay the same.

  • For example, if you already have health insurance that you're

  • happy with, you can keep it under this law.

  • And children under the age of 26 can stay on their parents plan.

  • If you already have Medicaid coverage,

  • then you're going to stay on that too.

  • Or you can if you wish.

  • In fact, many states are expanding

  • Medicaid to cover more people.

  • So now, let's talk about what's changing.

  • There are several things.

  • First there's this thing called the individual mandate.

  • Most Americans will be required to have

  • some form of health insurance.

  • This is a sweeping change for a country with an estimated

  • 30 million uninsured residents.

  • But how do you enforce something like that?

  • By 2014, everyone without health insurance

  • will need to pay a small fee.

  • During that year, for instance, the fee is going to be $95 per

  • adult, $47.50 per child.

  • The maximum a family will pay in 2014 is $285.

  • Now, those numbers are over the whole year, not month by month.

  • To make sure that people can find affordable insurance,

  • the ACA creates what are called Health Insurance Marketplaces.

  • These are virtual spaces run by the federal government,

  • or by your state, where customers

  • can see different plans and prices offered

  • by insurance providers.

  • So ultimately, this might allow you

  • to qualify for lower premiums, depending

  • on your income and your family size.

  • And regardless of what kind of insurance you have,

  • insurers will no longer be able to deny or revoke

  • coverage for preexisting conditions.

  • And women won't have to pay more than men for insurance either.

  • Finally, right?

  • Insurance will also cover preventative care.

  • So this would be stuff like mammograms,

  • and checkups, and screenings, and so on.

  • Then there's the 80/20 rule.

  • Insurers will generally be required to spend at least 80%

  • of the money they get from premiums

  • on-- wait for it-- actual health care.

  • If your insurer spends too much on overhead,

  • then you're going to receive a rebate.

  • Finally, the laws also require companies to publicly justify

  • rate increases of over 10%.

  • And they are banned from imposing lifetime dollar limits

  • on benefits.

  • This act also affects your employer,

  • whether you work for a large company or a smaller company.

  • A smaller business, one with less than 50 employees,

  • can visit the small business health options program,

  • or-- get this-- SHOP.

  • Right?

  • A government loves an acronym-- to compare and purchase

  • affordable health plans.

  • Additionally, some of these businesses

  • might be eligible for tax credits

  • if they get coverage through SHOP.

  • The rules are a little bit different for bigger

  • businesses.

  • In 2015, they have to make what's

  • called an employer shared responsibility payment if they

  • don't provide insurance meeting a minimum value standard,

  • or if one of their employees gets a better

  • deal in the individual marketplace.

  • Since states are implementing the act in different ways,

  • it's very important for you to check

  • on the specific plans of your home state.

  • So that's it.

  • If you'd like to learn more specifics about the Affordable

  • Care Act, check out www.healthcare.gov

  • for more information.

  • And hey, while you're online?

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Hey, everybody.

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