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The Affordable Care Act (ACA) gives individuals and families access to health insurance. The law was enacted in 2010 with three primary goals:1
  1. Expand availability of affordable healthcare coverage.
  2. Improve access to coverage for low-income Americans.
  3. Support medical care that helps lower costs.

Since becoming law, the ACA has helped 20 million Americans gain coverage, lowered costs for seniors, and eliminated the practice of charging women higher premium rates.2

Who Qualifies for the Affordable Care Act?3

To be eligible for an Affordable Care Act (ACA) insurance plan, you must:

  • Live in the United States.
  • Be a U.S. citizen or national (or be lawfully present).
  • Not be incarcerated.

What Does the Affordable Care Act Cover?4

The Affordable Care Act (ACA) provides many rights and protections for consumers that are designed to make health insurance easier to access and understand. It includes protections for people with prior health conditions, young Americans, and no-cost preventive services. Here are some of the features of the ACA:

  • People with pre-existing conditions are covered without being charged higher premiums.
  • Young adults have more coverage options.
  • The ACA ended lifetime and yearly dollar limits on coverage for essential health benefits
  • The law holds insurance companies accountable for premium rate increases.
  • Preventive care is covered without out-of-pocket costs.
  • Insurance companies cannot cancel your policy if you get sick.

ACA Subsidies Can Help Reduce Your Costs5

If you qualify, there are two subsidy programs available to help lower the cost of Affordable Care Act (ACA) monthly premiums or out-of-pocket expenses:

  1. Premium Tax Credit: Families earning between 100% and 400% of the Federal Poverty Level (FPL) can lower or cover the cost of premiums either by reducing their monthly premium cost, or paying the full premium amount each month and receiving a credit on their federal income tax. In 2021, eligible income is from $12,760 to $51,040 for an individual and from $26,200 to $104,800 for a family of four.
  2. Cost-Sharing Reduction: Families earning between 100% and 250% of the FPL can have out-of-pocket costs such as deductibles, copayments, and coinsurance lowered if they purchase a silver-level ACA plan.

When Can I Enroll in an Affordable Care Act Plan?

The Open Enrollment Period (OEP) for Affordable Care Act (ACA) health plans for most states runs from November 1 through December 15.6 But some states may choose to extend their OEP deadline. Check your state’s enrollment dates here. You can enroll outside of OEP under certain circumstances such as a moving, having a baby, getting married, or losing your employer coverage.7

Find an Affordable Care Act Plan Now

Ready to see what Affordable Care Act (ACA) plans are available in your area? The HealthMarkets customer shopping experience makes it easy. Answer a few quick questions, then our FitScore® technology finds plans that best match your needs. Compare plans, see up-to-date prices, and apply for coverage at no cost to you.


1. U.S. Centers for Medicare and Medicaid Services. Retrieved from Assessed January 8, 2021. 

2. Center for American Progress. March 23, 2020. Retrieved from 
3. Retrieved from Assessed January 24, 2021. 
4. U.S. Centers for Medicare and Medicaid Services. Retrieved from Assessed January 8, 2021. 
5. Kaiser Family Foundation. October 30, 2020. Retrieved from 
6. U.S. Centers for Medicare and Medicaid Services. Retrieved from Assessed January 8, 2021. 
7. U.S. Centers for Medicare and Medicaid Services. Retrieved from Assessed January 8, 2021. 

HealthMarkets’ FitScore® intends to identify plans that fit your needs. You should carefully review official plan materials.

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