The Affordable Care Act aims to expand Americans' access to health care and reward health care providers who deliver effective, coordinated care. Its chief reforms include creating a health insurance marketplace where consumers can purchase coverage, requiring insurance companies to cover people with pre-existing conditions, and expanding the Medicaid program to include low-income adults in states that choose to participate. The ACA is undergirded by an "individual mandate" requiring almost all Americans to have health insurance coverage or face a penalty at tax time, starting with the 2014 tax year.
What Does Expanded Access Look Like?
Since October 2013, the uninsured rate among U.S. adults has fallen by 35%, according to the U.S. Department of Health & Human Services (HHS).
About 11.4 million Americans purchased health insurance coverage through the federal or state health insurance marketplace during the 2015 open enrollment period.
Insurance companies can no longer refuse to provide coverage based on pre-existing conditions. They're also barred from ending coverage arbitrarily if patients become ill.
Most health plans must offer certain preventive services at no cost to the patient.
Young adults who are 26 years old or younger may be eligible to be covered on a parent's health insurance.
Access to mental health and substance abuse disorder services has been expanded.
Medicaid expansions in 28 states have extended coverage to millions of low-income and disabled patients, according to the HHS. In addition, 2.3 million young adults under age 26 now have coverage through their parents' plans.
What's Changing for DOs?
Along with expanding consumers' access to health care, the ACA seeks to improve the quality of U.S. health care by rewarding providers who provide efficient, data-driven, coordinated care. For example: