Health Care Reform

Summary of Terms, Definitions, Marketplaces, Timeline and Other Info Related to the Law

In the U.S., Health Care Reform refers to the overhauling of America’s healthcare system. This includes changes that affect the ever increasing costs of national health care by individuals, families, and the government. Also, addressing the benefits people receive and how people obtain health insurance.

In the new law that was passed in 2010, patient’s rights or protections were addressed as well as creating new rules for the insurance industry and for all U.S. citizens including legal immigrants. Goals were to reduce the number of uninsured, making healthcare more affordable and improving quality of care.

Common Terms Used to Refer to the Health Care Reform Bill

  • PPACA (Patient Protection and Affordable Care Act) – legal name
  • ACA (Affordable Care Act) – shorter version of the legal name
  • Healthcare Reform –common name

Why did we need the Affordable Care Act?

Historically, the U.S has spent considerably more on its healthcare compared to other high income countries in the world. Before the ACA, the last major healthcare legislation in the U.S. passed in 1965 when Medicare and Medicaid were put into place.  Some say, attempts to bring about reform go back to 1989 when the conservative Heritage Foundation proposed an individual mandate and a market based approach for healthcare. This proposal addressed the issues created by the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986 which required nearly all hospitals to provide emergency care to all who needed it, regardless of ability to pay. The costs of those who were treated that were unable to pay were often passed on indirectly to the government and to individuals in the form of higher insurance premiums and higher taxes. From 1989 through 2008, many attempts at healthcare reform were proposed.  However, all of these attempts to effect any major healthcare legislation failed.

How did the Health Care Reform law come about?

President Obama made a big push in 2009 to have congress construct a new Health Care Reform Law.

The following topics were controversial subjects as the new law was being formed:

  • The Mandate
  • Universal healthcare
  • Individual and/or Employer Mandate
  • Federal funding of birth control/abortion

The following examples were used, in part, as a model in constructing the new Health Care Reform Law:

  • The Massachusetts’ State Connector Exchange enacted in 2006
  • The Healthy Americans ACT or HEART was introduced in 2007 but later died in committee

The U.S. House and the Senate debated healthcare reform issues until the ACA was finally signed into law on March 23, 2010.

U.S. Health Care Reform Time Line

1965  –  Medicare and Medicaid legislation passed

1986  –  Emergency Medical Treatment and Active Labor Act passed

1989 – 2007  –  Many proposals for Healthcare Reform were considered

2008  –  Healthcare Reform was a major topic during the General Election

January 20, 2009  –  Barack Obama sworn into office as President

February 2009  –  President Obama began work on Healthcare Reform

2009 – 2010  –  Ongoing congressional negotiations

March 23, 2010  –  PPACA was signed into law by President Obama

2010 – Future  –  The ACA rolls out in stages mainly over the first 4 years 

2013 -2014  –  End of 2013, the first Open Enrollment began for 2014 effective dates

How does it affect you?

  • Financial help – People who qualify, can receive tax credits to lower their monthly health insurance bill from private insurance carriers
  • Preventative care is free.
  • Pre-existing conditions eliminated – People can apply without consideration of current or previous health issues
  • Shopping for health insurance is easier – The Health Insurance Marketplace and other State Exchanges have been created to help provide an easier way to compare plans and understand benefits for the public
  • New rules to understand – Because of the new law, people need to be aware of important factors such as income, tax filing status, and where and when to apply


Not sure how Obamacare affects your health care plans in California? Learn how the ACA works in California, including benefits, costs and enrollment.

Covered California is the Golden State’s official health exchange marketplace where individuals, families and small businesses can find high-quality, low-cost California government health insurance.

Learn about Obamacare income guidelines in California using our income limits chart, and see if you’re eligible for government assistance.

Learn about the Covered California website. Find easy online enrollment. Set up your account, log in, buy insurance and more on the California health marketplace website.