How Obamacare Changed Workplace Insurance

by Nancy Metcalf Health Writer

There’s a good chance that you get your health insurance through your employer, like nearly half of Americans. While it’s true that the Affordable Care Act (also known as Obamacare) was designed mainly to help people who didn’t have access to an employer plan, it also made some important changes to the coverage that workers get through their jobs. Here are five of those changes.

1. Young adult coverage was added. Many employers used to kick their employees’ children off health insurance when they turned 19 or graduated from college. The Affordable Care Act allows adult children to stay on their parents’ plans until they turn 26.

2. Lifetime coverage limits were abolished. Before the Affordable Care Act, nearly 6 in 10 employees were in plans that cut them off for life if they ran up more than a few million dollars in medical expenses. Most people never had to worry about this happening, but the limits posed a real problem for those with medical catastrophes, such as premature infants with long stays in intensive care, people who needed costly cancer treatments, or patients who had organ transplants. Under the ACA no health insurance can have annual or lifetime limits.

3. Preventive services were made free. Even if you have a high-deductible plan, the ACA says your health insurance has to cover a long list of preventive services free of charge. For working families, the most significant are contraception, prenatal care, immunizations, and well-child visits.

4. Long waits for coverage were eliminated. Employers used to be able to wait as long as they wanted before putting a new hire on the company health plan. The ACA says it has to happen within 90 days.

5. The right to appeal decisions was added. About 6 in 10 covered workers are in “self-funded” plans, meaning that employers pay the cost of their care directly, using insurance companies only to administer the plan. Before the ACA, if you were in this type of plan you had no rights to appeal health coverage decisions to an impartial outside entity. Under the ACA, you do.

Editor’s Note: This is the fourth in a series of articles on the impact of the health-care proposals being introduced in Congress this year. You can weigh in by contacting your representative in the U.S. House or the Senate.

Nancy Metcalf
Meet Our Writer
Nancy Metcalf

Nancy Metcalf is an award-winning independent journalist specializing in health topics. A senior writer and editor for Consumer Reports for more than 25 years, she is a nationally recognized expert on health insurance and health reform.