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Insurance Marketplace 101



Benefits of the Affordable Care Act for Americans


 Better Value


  • Making Sure 80 Cents Out of Every Premium Dollar Goes to Your Care. Health insurance companies now have to spend at least 80 cents of your premium dollar on health care or improvements to care, or provide you a refund. In 2012, 8.5 million consumers received half a billion dollars in refunds – with the average consumer receiving a refund of around $100 per family. Moreover, 77.8 million consumers saved $3.4 billion up front on their premiums as insurance companies operated more efficiently as compared to 2011.


  • Transparency in Health Insurance Rates. Now insurance companies in every state must publicly justify any rate increase of 10 percent or more. Since this rule went into effect, the fraction of issuer requests for premium increases of 10 percent or more has dropped dramatically, from 75 percent to 14 percent. To date, the rate review program has helped save Americans an estimated $1 billion.


  • Stronger Consumer Protections. Insurance companies can no longer cancel your coverage because you get sick or because you made a mistake on an application. And they can no longer limit lifetime coverage to a fixed dollar amount. Already 105 million Americans no longer have a lifetime limit on essential health benefits, thanks to the law.


  • No More Denials Because of Pre-Existing Conditions. 129 million non-elderly Americans have some type of pre-existing health condition, including 17.6 million children. Today, insurers can no longer deny coverage to children because of a pre-existing condition, like asthma or diabetes, under the health care law. Today, health insurers can no longer charge more or deny coverage to anyone because of a pre-existing condition.


  • Keeping Young Adults on Their Parents’ Plans. The health care law has allowed 3.1 million young adults who would otherwise have been uninsured to stay on their parents’ health insurance plans until age 26.



Improving Quality and Lowering Health Care Costs

  • Free preventive care

  • Prescription discounts for seniors

  • Protection against health care fraud

  • Small Business Tax Credits


New Consumer Protections

  • Pre-existing conditions

  • Consumer Assistance


Access to Health Care 


Benefits for Women

  • Providing insurance options

  • Covering preventive services

  • Lowering costs


Young Adult Coverage

  • Coverage available to children up to age 26


Strengthening Medicare

  • Yearly Wellness Visit

  • Many Free Preventive Services for some seniors with Medicare


Holding Insurance Companies Accountable

  • Insurers must justify any premium increase of 10% or more before the rate takes effect

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