Affordable Care Act (ACA) basics

In 2010, President Obama signed into law the Affordable Care Act (ACA), also known as health care reform. While there have been other important laws affecting health insurance over the last four decades, the ACA is the most significant change since the 1970s.

Health care reform improves some important aspects of the health care system that, because UC already provides generous medical coverage, you may not have known needed improvement.

  • Everyone can get coverage. You rely on your health insurance, especially when you’re managing a health issue. It might sound strange to you if you’ve been enrolled in a UC plan for a long time, but some Americans were either locked out of buying medical insurance because of an illness — or couldn’t get help paying bills related to that illness for a significant period of time. As of Jan. 1, 2014, all Americans can join any medical plan without any exclusions for pre-existing health issues.
  • Everyone must get coverage. Now that the door is open to everyone, there’s no reason not to get coverage. In fact, starting Jan. 1, 2014, everyone must have medical coverage or pay a fine or tax. There are regulations on the kind of plan you must have — but all of UC’s medical plans meet all regulations. So, as long as you stay in a UC-sponsored medical plan, you’ll meet the minimum requirements for affordable coverage.
  • No more limits. When you’re really sick, bills can add up, and emotional stress can be really high. That’s why UC never caps our share of your medical bills. As long as you’re still juggling bills, the plan features are still in effect. But now all Americans will have this kind of financial security too. Specifically, there are no annual or lifetime limits on essential health benefits.

What the ACA means to UC

While the ACA improves the health care system, at the same time, this law imposes many new requirements on employers. Health care reform affects UC in three main ways.

  1. UC’s plans will be more heavily regulated. Health care reform puts in place many new rules. Some are one-time changes, but others require annual monitoring and administrative duties.
  2. The university has new costs. New taxes on large employers, as well as indirect taxes levied on insurance companies and medical equipment providers, also mean higher overall costs for UC’s plans.
  3. The health care landscape will keep changing. At the same time health care reform happened, new companies and new ways of providing medical care have emerged to help improve the health care system and help you interact with it in a better way. These shifts will bring new opportunities for UC – especially in our role as one of the largest health care providers in California.

Health Insurance Marketplace—“Exchanges”

Soon you’ll be seeing more and more information about the Health Insurance Marketplace, also called “exchanges.” In California the Marketplace is called Covered California. Marketplaces are intended for people who can’t get affordable coverage through their employer and also for small businesses. Anyone can shop in the marketplace. Since benefits-eligible employees have affordable coverage through UC, they are not eligible for the premium tax credits available through the marketplace.

What you can do to help keep costs down

Understanding health care reform will take time. As you learn and think about what the law means to you and your family, your everyday actions matter.

  • Make good choices during UC’s Open Enrollment this year.
  • Take care of yourself. Participate in the wellness program to get rewarded for getting and staying healthy. And make sure you and your family members get appropriate preventive care.
  • Develop a strong relationship with your doctor. He or she has your best interests at heart.
  • Keep learning. Stay curious about ways to better interact with the health care system. When consumers are better informed, change happens. Explore ways to get the most from your benefits.
  • Understand your benefits. Visit UCnet to learn more about UC's benefits.