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Seizing the Opportunity with the New Special Enrollment Period

The Affordable Care Act (ACA) encompasses various features aimed at improving access to healthcare, enhancing the quality of care, and providing financial assistance to individuals and families. Here are key features of the Affordable Care Act:

  • Health Insurance Marketplaces: Establishes state-based and federal Health Insurance Marketplaces where individuals and small businesses can compare and purchase health insurance plans.
  • Subsidies for Premiums and Cost-Sharing: Provides subsidies to eligible individuals and families to make health insurance premiums and out-of-pocket costs more affordable, based on income levels.
  • Medicaid Expansion:Expands Medicaid eligibility in participating states, providing coverage for more low-income individuals and families.
  • Essential Health Benefits: Requires health insurance plans to cover essential health benefits, including preventive services, maternity care, prescription drugs, and mental health services.
  • Protections for Pre-existing Conditions: Prohibits insurance companies from denying coverage or charging higher premiums based on pre-existing conditions, ensuring access to insurance for individuals with prior health issues.
  • Individual Mandate (No Longer Enforced): Previously required most Americans to have health insurance coverage or face a penalty, although this provision is no longer enforced as of 2019.
  • Dependent Coverage Extension: Allows children to stay on their parents' health insurance plans until the age of 26, providing extended coverage for young adults.

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