• Premium Subsidies for Low- and Middle-Income Americans: For individuals and families above the Medicaid threshold and up to 400% of poverty, federal income-based subsidies are provided for premiums and cost-sharing.  Applies to citizens and legal immigrants.
• Private Sector Health Insurance – Competitive Marketplace:   States set-up health care “Exchanges” where people purchase private health insurance (with subsidies if they are low income); and a Federal health insurance exchange for States that do not establish their own.
• No Discrimination against Preexisting conditions:  Prohibits insurance companies from denying coverage or charging higher premiums due to preexisting conditions.
• No Lifetime Limits on Benefits:  To protect people with chronic and acute conditions, insurance plans are prohibited from capping lifetime benefits.
• Medicaid Expansion for Low-Income Americans:   Individuals and families below 133% of poverty ($33,534 for a family of 4) are entitled to Medicaid health coverage, which charges no premiums.  Available in States that have accepted the federally-funded Medicaid expansion. Applies to citizens and legal immigrants.
• Essential Health Benefits: requires non-grandfathered health plans in the individual and small group markets to cover essential health benefits, which include items and services in the following ten benefit categories: (1) ambulatory patient services; (2) emergency services; (3) hospitalization; (4) maternity and newborn care; (5) mental health and substance use disorder services including behavioral health treatment; (6) prescription drugs; (7) rehabilitative and habilitative services and devices; (8) laboratory services; (9) preventive and wellness services and chronic disease management; and (10) pediatric services.
• Small Employers (25 or fewer) entitled to a tax credit up to 50% of employer’s contribution.
• Children up to Age 26: can remain on their parents’ plans.
• CRS: Overview of the ACA Medicaid Expansion (Jun 2021)
• CRS: Supreme Court Dismisses Challenge to the Affordable Care Act (Jun 2021)
• CRS: Patient Protection and Affordable Care Act (ACA): Resources for Frequently Asked Questions
• CBO: Affordable Care Act Page