The Affordable Care Act (ACA), commonly known as Obamacare changed the way health care is delivered and received in New Jersey and across the country. The goal of the ACA is to reduce costs and improve the quality of care. It is also meant to guarantee more choice and provide for more accountability. The Act has had a significant effect on hospitals, doctors, and the patients they serve. Following is a summary of the major ways patients are affected by the ACA.

• More people have Medicaid coverage. As a result of the ACA, Governor Christie expanded Medicaid to include many more New Jersey residents. Most new enrollees began receiving services in January 2014.
• Insurance through the Health Insurance Exchange. You are able to buy insurance through a health insurance exchange (a marketplace where rates and services are compared and purchased) if you do not receive coverage through your employer and are not eligible for Medicaid.
• Elimination of pre-existing condition exclusions. If you or your dependent has a pre-existing health condition, such as cancer, type I diabetes, or autism, insurance companies may no longer charge higher premiums, limit benefits, or deny coverage.
• Extended coverage for dependents. Young, healthy children are now allowed to stay on their parent’s private insurance until age 26.
• Electronic record keeping. Patients have better access to their medical records, and it is easier for them to have their records shared with other specialists.
• Preventive care services expanded. Health plans are required to cover recommended preventive services at no additional charge to the patient. Examples of these services include colonoscopies, mammograms, and annual wellness visits for seniors on Medicare.
• Closing of the “Donut Hole.” The ACA closed Medicare Part D’s Prescription Drug Gap (also known as the donut hole). As a result, patients have experienced a 50% or more savings on many brand-name drugs.
• Increased funding for health centers. The ACA provided increased support and funding to health centers across the state, including school-based health centers that provide primary care, dental care, and behavioral and other services.
• Increased doctor control. The ACA put control back in the hands of physicians, instead of the insurance companies, so you are more able to follow the advice of your physician without paying extra costs out of pocket.
• Elimination of annual and lifetime limits. Insurance companies can no longer cap your coverage at a certain cost per year or over your lifetime.
• Increased care in underserved communities. The ACA created new incentives for doctors, nurses, and physician assistants to work in certain underserved areas and with indigent patient populations. This is done through payment increases for providers in certain areas and Medicaid reimbursement rates that match Medicare rates.
• Better overall care. Physicians and hospitals are rewarded for improved patient health outcomes. For example, the ACA funded an initiative called Partnership for Patients, which brings doctors and nurses together to develop strategies to reduce preventable illnesses that spread in hospital facilities. As a result, hospitals throughout the state experienced a decrease in infection rates and other preventable problems.

While the full impact of the ACA remains to be seen, there is no doubt that its effects have been far-reaching and life-changing for many Americans.​

This information last reviewed: Oct 23, 2017