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The Affordable Care Act: What’s Changed and What Has Stayed the Same

Accounting Support • Feb 11, 2022
This year, almost 14 million people signed up for health coverage through the Affordable Care Act. Compared to previous years, this is a staggering 21% increase. Government-
The Affordable Care Act: What’s Changed and What Has Stayed the Same

This year, almost 14 million people signed up for health coverage through the Affordable Care Act. Compared to previous years, this is a staggering 21% increase. 

Government-offered health coverage has largely been controversial over the years, yet it continues providing extensive coverage for many households and families. Since its birth over a decade ago, the Affordable Care Act has undergone many changes, but its core remains the same: offering more coverage for citizens. 

Are you interested in learning more about the Affordable Care Act? We have put together a complete guide that addresses changes, requirements, and what has stayed the same heading into 2022, so keep reading for more information!

What Is the Affordable Care Act?

The Affordable Care Act (ACA) is also known as the Patient Protection and Affordable Care Act. It helps provide insurance coverage to many Americans, as well as:

  • Improve healthcare quality
  • Improve health insurance
  • Change insurance regulations
  • Reduce spending in the healthcare industry

One of the main areas that the ACA requirements changed is pre-existing health conditions. Before the ACA, many insurance companies would drop or raise premiums on these individuals. 

Cancer and diabetes were two diagnoses that left Americans without the ability to get insurance. With changes made by the ACA, coverage would be offered to these individuals. 

Children and young adults could also remain on parental insurance plans until 26. It also opened tax benefits for small businesses with less than 25 full-time employees. Under the ACA, these businesses could provide health insurance coverage with funding.

Under the ACA, more Americans have insurance now than ever before. 

Affordable Care Act Timeline

The ACA was officially signed in March 2010 but was first gaining rumblings in the Senate and House in 2009. While controversial at the time (and to this day), the ACA immediately allowed insurance plan holders to remain on their current one. But it required new criteria for enrolled plans after March 23, 2010. 

Between that date and January 1, 2014, any insurance plans had to meet new standards. Since the signing of the ACA in 2010, there have been some significant changes in these areas:

  • Penalty fees
  • Exemptions
  • Work requirements
  • Enrollment

Most of these occurred during the Trump presidency, and there will likely be more changes in the future. 

ACA in 2010

One of the biggest years for the ACA was 2010. During the first three months, the government issued funds for people who could not get health insurance. Small businesses also started qualifying for tax credits.

One of the biggest difference-makers was the Pre-Existing Condition Insurance Plan (PCIP). The PCIP started in July 2010 and helped make insurance available for all Americans, even those previously denied because of previous medical diagnoses. 

If you haven't heard of the PCIP before, it is because it no longer exists. After expiring in 2014, insurance plans continue following guidelines that cannot deny individuals health coverage for a pre-existing condition. 

Later in 2010, the government released guidelines on the Medicare Part D gap. Before the ACA, the 'coverage gap' was making big headlines. This donut hole in Medicare Part D guidelines meant people were paying full price for prescription medications after reaching their coverage limits.

Many Americans fell into this expensive hole and would pay high amounts for the prescription drugs before Catastrophic Coverage ensued. The ACA has worked diligently since 2010 in reducing the gap, although it still exists in a smaller amount today. 

ACA in 2011

One of the most significant changes in 2011 under the ACA was insurance coverage for young adults. Now, they could stay on plans until their 26th birthday. 

Before the ACA, most uninsured individuals were young adults. Almost 30% of this age group did not have coverage, and approximately half of these individuals reported difficulties paying medical bills. The result?

Between 2010 and 2016, over six million young adults between 19 and 25 received health coverage. 

Preventive care coverage was also extended, and most plans either cover most or all preventative care. This made access easier for women seeking out OBG/YN or emergent care visits. It also lifted restrictions on prior insurance authorization for primary care providers.

How the ACA Changed in 2014

2014 was another big year for the ACA. Insurance companies had to extend coverage to all adults who applied, and fines began for people who did not sign up. For low-income households, premiums helped them pay for coverage.

Additionally, the PCIP expired since insurance companies now had reforms that covered all individuals, regardless of past medical history. 

The Trump Era

In 2016, a new presidential era arose, which put many of the laws and regulations in question. Rather than repealing the ACA, President Trump made significant changes that affect health coverage today. 

The tax penalty for not enrolling in an insurance plan was removed. Additionally, Medicaid expansion and coverage required new eligibility.

Under these changes, states continued offering Medicaid, but adults had to prove they were working or attending school. Lastly, President Trump discontinued payments to insurance companies that were part of the ACA exchange. These payments essentially enticed insurance companies to keep premiums and out-of-pocket costs lower for citizens. 

How to Apply for ACA 

Applications for health coverage under the ACA start at healthcare.gov. It is the nation's marketplace for health coverage and lets you quickly see what kind of coverage you can get. 

Some questions that the application will ask about for ACA requirements are:

  • Income
  • Household
  • Where you live
  • Taxes
  • Estimated income

Typically, the enrollment period is at the end of each year unless a life event warrants a change in coverage

ACA Reporting Services

Affordable Care Act reporting software can help ease your burden at work. Our reporter helps ensure your company follows compliance regulations and decreases the amount of time spent filling out paperwork and non-compliance letters. 

ACA reporting can be complex, time-consuming, and costly. Let us help your business out! Contact us today for a free demo and see how an ACA reporting tool can make compliance easier and cost-friendly.

Build and manage a better workforce with integrated HR solutions from ADP Marketplace partners like Points North.

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