What Is Obamacare?

Just basics that everyone should know, though many don't

Only 37 percent of Americans say they're in favor of the 2010 health-care law. When you describe specific changes happening under the law, though, closer to 70 percent are on board with them. That's among data from Kaiser Family Foundation that was highlighted on All Things Considered this weekend. Also of note: 50 percent think the law gives health-care subsidies to undocumented immigrants, 80 percent don't know if their state will expand Medicaid, and 40 percent think the law sets up "death panels." 

Even though the law passed three years ago, there's still a lot of misunderstanding out there about the basics of what it is/does. So hopefully some people will find this of use. I totally relate to situations where everyone is talking about something for a while, and you never really got it, and then before you know it everything you try to read is beyond comprehension because it assumes everyone already knows the basics. So you just nod passively when people bring it up and try to change the subject and continue not to know about it. I'm that way with Syria and food trucks. 

If you consider yourself conversationally fluent in Affordable Care Act banter, then what I write here will bore you. Detailed discussion is at healthcare.gov -- and also like, everywhere else.

Obamacare ... okay to call it that?

Yes. The name used to have a negative vibe, but the President has since owned it

Patient Protection and Affordable Care Act = PPACA = ACA = Obamacare = "the health-care law"

None of these in particular imply that you love or hate Barack Obama or intend to support or subvert the law.

What does it do for people?

SHARK300200.jpgObamacare does not mandate that anyone bend over. This is a playful sodomy reference. (RebeccaCook/Reuters)

The stated purpose is to "increase the number of Americans covered by health insurance and decrease the cost of health care." The most widely relevant and talked-about parts are that no one will be excluded from getting insurance, and everyone will have to get insurance.  

Insurance companies can't refuse to cover people like they used to, and they can't revoke coverage when people get sick. People won't be forced to pay extra for insurance because of pre-existing conditions. There will be a limit on how much insurance companies can legally profit, and they will eventually have to cover all kinds of preventive care. 

Those things, among other measures aimed at containing U.S. health care spending, which was $2.6 trillion last year ...


This law passed three years ago. It doesn't feel like much has changed.

Changes are rolling out over a ten-year period. So far, things have mostly affected insurance companies and the industry side. Increases in health care spending have (coincidentally?) slowed since 2010. 

The most disputed part of the law -- the "individual mandate" that requires "most Americans to have "minimum essential health insurance coverage" (the part that drove the ACA to the Supreme Court last Spring, where it was upheld) -- goes into effect in January 2014.

45 million Americans don't have health insurance, though. How are so many people supposed to get it by 2014?

First, state and federal governments are setting up exchanges. That will start in October.

What are exchanges?

Exchanges are markets where small businesses and people can shop for insurance and compare prices and benefits. They'll be on web sites.

Presented by

James Hamblin, MD, is a senior editor at The Atlantic. He writes the health column for the monthly magazine and hosts the video series If Our Bodies Could Talk.

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