After more than a year of negotiations and public debate, the US Congress passed and the president signed in March 2010 the Affordable Care Act (ACA), a health care reform law designed to provide near-universal health coverage at affordable prices. The changes mandated by the Affordable Care Act potentially affect all Americans, both as patients seeking medical care and as consumers looking for the right plan. Regardless if you are young or old, or receive insurance through your employer or purchase coverage individually, you should be familiar with the far-reaching changes outlined in the Affordable Care Act.

The biggest immediate changes affected those with families as well as individuals who lack coverage because they are sick. Children can now remain on their parents' insurance plan until the age of 26, and cannot be dropped due to pre-existing conditions. Nor can health insurers drop policies on those who have fallen ill, or refuse to cover people who have pre-existing conditions. In addition, lifetime caps on coverage are prohibited under the Affordable Care Act, and annual limits for most plans were phased out in 2014, so that people with catastrophic illness are at less risk of bankruptcy due to unpaid medical bills. The Affordable Care Act also mandates that private insurance coverage must offer certain preventive screenings and services for children and adults at no cost, including screenings for high blood pressure, cholesterol, diabetes, breast cancer, and obesity, among other conditions, as well as certain vaccines and other preventive services.

The ACA also enacted changes for low-income and middle-class Americans. Individuals and families whose income is 100-400 percent of poverty level may be eligible for subsidies and premium tax credits that can help reduce the cost of health insurance plans and keep premiums between 2 and 9.5 percent of income. In addition, the Affordable Care Act expanded Medicaid in several states, making it easier for low-income individuals and families to receive coverage.

The Health Insurance Marketplace, also called the exchange, opened in October, 2013. People are required to wait for annual open enrollment periods to apply for new healthcare coverage. December 15, 2019 was the last day to enroll in or change plans for benefits to become effective on January 1, 2020. In every state, open enrollment for ACA-compliant 2021 health coverage for individuals and families will start on November 1, 2020. In most states, it will end on December 15, 2020. People who are uninsured or who buy their own, private health insurance can use the exchange to search for affordable healthcare plans, based on their income and other factors. People who are covered by an employer-sponsored plan can also search for coverage through the exchange, however, if you are eligible for coverage under an employer-sponsored plan, you most likely won't be eligible for a healthcare subsidy. Access the Health Insurance Marketplace at www.healthcare.gov.This section helps you make smart decisions about health insurance to both safeguard your health and protect your finances.