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The Affordable Care Act

Two years after its passage, the health care law's future is in the hands of the U.S. Supreme Court

En español | The Affordable Care Act (ACA) was signed into law on March 23, 2010. Both before and after its creation, supporters and opponents argued the legislation's pros and cons, and state governments and federal courts have both supported and challenged some of its provisions, many of which are scheduled to take full effect by January 1, 2014.

AARP supported passage of the Affordable Care Act because the law contains protections that benefit our members, their families and other Americans age 50 and over, for whom the lack of health insurance coverage — or affordable coverage — is a serious challenge.

The ACA was debated before the Supreme Court on March 26, 27 and 28, during a rare multi-day schedule of oral arguments.

AARP filed amicus (friend of the court) briefs providing the justices with information about how people ages 50 to 64 who don't have employer-based coverage are routinely denied affordable health insurance because of their age and pre-existing conditions. In 2010, the number of uninsured adults ages 50 to 64 in the United States reached 8.9 million — 3.7 million more than in 2000.

Despite the debates and court challenges, many parts of the Affordable Care Act are now in effect and in use. AARP is focused on helping our members and the public understand the many provisions of the law specifically designed to protect older people and their families.

Current and future provisions of the law that benefit people 50 and over and their families include:

If you have insurance:

  • As long as you pay your premiums, an insurance company can no longer drop your coverage if you become sick or disabled;
  • An insurance company can no longer place lifetime dollar limits on your health coverage;
  • Many private health insurance plans must now cover more preventive care services, such as mammograms and other screenings, at no additional cost to you.

If you are uninsured or have a pre-existing condition:

  • The law provides a way for many adults with pre-existing medical conditions who have been denied coverage to purchase health insurance, and insurance companies can no longer deny coverage to children up to age 19 who have pre-existing conditions;  
  • The Affordable Care Act allows young adults up to age 26 to remain on or be added to a family's health insurance plan, thus reducing the number of uninsured young adults and helping ease parental worries. In the past, young people were typically forced off their family's health plan upon turning 18 or 21, or graduating from college;  
  • Starting in 2014, insurers may no longer deny coverage to anyone with a pre-existing health condition. Also in 2014, new health insurance "exchanges" will provide better insurance access and more options to self-employed people, small businesses and others who have been denied coverage or affordable coverage.

If you have Medicare:

  • Annual wellness visits are provided at no additional cost to you, as are certain preventive care services, such as immunizations and screenings for cancer or diabetes. In 2011, more than 32.5 million Americans in traditional Medicare used one or more of the program's free preventive services, and more than 1 million people took advantage of Medicare's new annual wellness visit;
  • People with Medicare Part D now receive discounts on prescription drugs while in the coverage gap known as the "doughnut hole." (In 2011, 3.6 million people in Medicare saved $2.1 billion, or an average of $604 per person, on prescription drugs.) The Part D discounts will gradually increase until 2020, when the doughnut hole will disappear;
  • The law provides new resources to fight waste, fraud and abuse in the Medicare program.

If the Affordable Care Act is struck down in whole or in part, many of the provisions specifically designed to protect older adults and their families will be in jeopardy. The Supreme Court's ruling is expected in late June.

Also of interest: Your personalized guide to the health care law. »

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