Copy editor: Kurt Holliday, Communications Specialist, Pennsylvania Public Health Training Center
On October 1, 2013, enrollment began for the Marketplaces under the Affordable Care Act (ACA) for coverage beginning on January 1, 2014. Signed into law in 2010, the ACA makes critical changes to health insurance in the United States. Some of the ACA changes (extending health insurance coverage of children until age 26 on parents’ insurance plans, for example) took effect in 2010. In January 2014, the most important changes go into effect.A key component of the ACA is to increase the accessibility of health insurance for all Americans. To do this, the Health Insurance Marketplaces were established. The Marketplace in each state is made up of private health insurance plans that must cover a basic set of benefits, including preventative care (such as screenings and check-ups), other doctor visits, prescriptions, hospitalization, family planning and maternity care. It provides people with different plan options and costs. Approximately half of the states are operating their own Marketplace; the federal government is operating the Marketplace in the 26 states that opted not to create their own.
People who purchase insurance through the marketplace may be eligible for tax credits or a cost-sharing reduction, depending upon their income. Income also determines how much people have to pay for copays, co-insurance and deductibles. In some states people whose annual incomes are below 138% of the Federal Poverty Level ($15,856) may be eligible for premium-free coverage through Medicaid. People who can afford to purchase insurance may face a penalty fee if they decide not to buy it.
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