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Secure and Expand Health Insurance Coverage

HHS is working to implement provisions of the Affordable Care Act to secure and expand access to quality, affordable health insurance coverage and strengthen consumer protections in health insurance.  These reforms put Americans back in charge of their own health care by creating an important foundation of patients’ rights in the private health insurance market and increasing health coverage choices for families.

Make Coverage More Secure for Those Who Have Insurance

HHS is making coverage more stable and secure through insurance market reforms.  Because of protections in the Affordable Care Act, no one can be excluded from coverage based on their pre-existing health conditions.  Insurers are now prohibited from putting lifetime dollar limits in health plans, which could often leave people without medical care when it was most needed.  As part of securing and expanding health insurance coverage to individuals, HHS is working to enforce the protection of patients’ privacy and civil rights. HHS is working with states to identify unreasonable rate increases by health insurance plans, and is requiring new health plans to implement an appeals process for coverage or payment decisions.  Additionally, health insurers are generally required to spend 80 or 85 percent of health insurance premiums on medical care and quality improvement, not on profits and overhead.

Expand Consumer Choice and Support Informed Decision-Making

HHS is ensuring more Americans have health insurance, expanding consumer choice, and supporting informed decision-making about health coverage.  The Health Insurance Marketplace gives individuals and small businesses that are uninsured or looking for other options a way to find quality coverage that suits their needs and budget.  Consumers in every state will be able to see all the health plans available in their area, and new premium tax credits and cost-sharing reductions will help ensure coverage is affordable for many Americans.  The Marketplace opened for enrollment from October 1, 2013 through March 31, 2014, with coverage beginning as soon as January 1, 2014.  The Marketplace will guarantee that Americans have a choice of quality, affordable health insurance even in the event of a job loss, job switch, move, or illness. 

Provide Access to Mental Health and Substance Use Disorder Services

The Affordable Care Act will provide more Americans with access to quality coverage for mental health and substance abuse disorder services.  All new small group and individual private market plans will be required to cover mental health and substance use disorder services as part of the Affordable Care Act’s requirement to cover Essential Health Benefits, and must comply with parity requirements.  HHS, in partnership with the U.S. Departments of Labor and the Treasury, recently issued the final rules governing these requirements under the Mental Health Parity and Addiction Equity Act of 2008.

Increase Health Insurance Coverage for Low-Income Populations

HHS is working to extend Medicaid coverage to millions of low-income individuals who were previously not eligible for coverage.  By simplifying complex eligibility rules and systems for processing most Medicaid applications, HHS is establishing a streamlined system of coverage to meet consumers’ needs seamlessly and efficiently, improve quality, and lower costs.