The Patient Protection and
Affordable Care Act (ACA) was
enacted on March 23, 2010.
Successful implementation requires
cooperation between key
stakeholders, federal and state
agencies, and reform advocacy
organizations. Because the fifty states vary greatly, each state’s implementation process will be unique.
the state’s population is primarily
White, there are communities with
substantial racial diversity, which
will present Oregon with varying
challenges as it strives to
implement health reform that
works for all residents.
ACA is designed to address these concerns by providing affordable access to health insurance coverage to those individuals who would otherwise be unable to obtain coverage, and to extend current benefits and services provided by Medicaid (a federal and state funded public insurance program that provides health insurance coverage for low-income and disabled individuals and families).
Insurers will not be allowed to drop any insured person because he/she gets
sick or develops a chronic health condition. In addition, ACA allows individuals
to renew health insurance coverage regardless of their health status.
Insurers cannot exclude people from coverage if they have a pre-existing
condition (e.g., asthma, diabetes, or any other long-term condition) or past
Effective Immediately: ACA makes tax credits available to qualifying small businesses to
help them afford coverage for their employees. These tax credits could total up to 50% of
a business’s health insurance premiums. In 2008, Oregon had over 77,468 small
businesses,6 which represented almost 78% of the state’s employers.7
Effective January 2014: ACA requires that states create an insurance market “exchange”
– a marketplace where people will be able to compare and shop for health insurance.
This will make access to health plans easier and more efficient. U.S. citizens, legal
immigrants, and small businesses will be able to purchase insurance through these
Effective January 2014: ACA provides a tax credit to qualified individuals so that they may
purchase health insurance through the exchanges. Qualification for the tax credit will be
based on the individual’s household income and his/her number of dependents. A
person who earns between 133% and 400% of the federal poverty level8
Effective July 2010: High-risk pools are designed to provide health insurance coverage to
people who were previously uninsurable due to a pre-existing condition. The Department
of Health and Human Services (HHS) will allocate approximately $66 million for Oregon to
implement a high-risk pool that complies with ACA’s requirements.9 The high-risk pool
may provide services to approximately 6,700 Oregonians, while also saving the state $65
million over the next three years.10
Effective January 2014: ACA contains provisions that will create new eligibility
requirements for Medicaid. For example, adults under the age of 65 earning less than
133% of the federal poverty level, may be eligible to apply regardless of whether they
have children. It is estimated that approximately 294,600 Oregon residents may be
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