<img height="1" width="1" src="https://www.facebook.com/tr?id=2256810414611809&amp;ev=PageView &amp;noscript=1">

What Is the Affordable Care Act (ACA)

What is the Affordable Care Act or ACA? How does the Affordable Care Act affect medical and dental practices? We'll walk you through everything you need to know to stay on top of the latest regulations. Keep reading! 

What Is the Affordable Care Act (ACA)

In 2010, a sweeping overhaul to the U.S. Healthcare system was enacted. Born from over 1,000 pages of provisions, the Affordable Care Act, otherwise known as “Obamacare,” was passed. Its creation, praised by many, was proposed to reduce the amount of the uncompensated healthcare fee’s the average American family pays.

Considering the scope of legislation approved by the 111th Congress, 5-10 years of progressive implementation has been the result. This gradual implementation has left some wondering, “What is the Affordable Care Act in its present form?” and “How does the ACA affect my health practice or family?” Let us dive in.

Eliminate Questions about the Affordable Care Act—Obamacare Explained

Although individual coverages depend on the actual plan chosen, there are ten required medical services for all options. Under the ACA, each health plan must account for the following:

  1.     Preventative Care
  2.     Emergency Care
  3.     Outpatient Care (When no hospital admission takes place)
  4.     Hospitalization
  5.     Newborn and Pregnancy Care
  6.     Mental Health and Substance use disorder services
  7.     Rehabilitative Services
  8.     Pediatric Care
  9.     Lab Services
  10. All pre-existing conditions must have coverage.

If you find yourself wondering if an ACA health plan is required to avoid a tax penalty, let’s clear up any confusion. You see, the individual mandate which required all Americans to either be insured or to pay a tax-penalty fulfilled an early purpose.

The penalty served to offset people undergoing hardships while needing to pay for medical care. In 2017, the penalty attached to the individual mandate was released. Although a few states have their own mandates, the Trump administration repealed the federal tax penalty until the end of 2020. 

Uncovering the Costs and Subsidies of the Affordable Care Act

For timely help to Americans with lower income-levels, subsidies are available.. These subsidies—otherwise known as tax credits, assist these individuals with paying their monthly premiums. The ACA also makes payments directly to insurance companies. Ideally, this share of cost helps keep insurance companies from raising their medical plan premiums.

As we will learn next, there are special considerations for small practices to examine. Understanding the nuances in deciding to insure your team is a bit tricky. 

Eliminate the Guesswork- Is the ACA Right for Your Practice?

Did you know, practices that employ fewer than 25 team members can receive a 50% tax credit? This tax credit (up to 50%) applies to small practices that offer the ACA plans to their team. If your office provides health insurance to early retirees (age 55-64) federal assistance is available. Your practice may also be able to assist team members in finding individual insurance on the health insurance exchange. Sometimes, a cheaper option for the employee. 

Having a family-owned or small practice brings the level of care in your community up. The specialized yet always personal care your small-practice provides should not be under-estimated. We at HR for Health  understand this. After all, when it comes to your passion for helping others, creating a positive force in the lives of those you serve is fundamental. We echo your sentiments. We understand that whether to provide health benefits for your employees or not is a significant one.  Reach out for help in finding the right health care professional for you.


Did you know that we at HR for Health monitor all the specific laws and regulations that affect your practice? If you have questions about compliance issues, please reach out to us. Schedule a call, call (877) 779-4747, or email compliance@hrforhealth.com now to learn more.

HR for Health is one of the nation’s leading Human Resources Management Systems (HRMS) used by small to mid-sized practices. 

Quick note: This is not to be taken as legal or HR advice. Since employment laws change over time and can vary by location and industry, consult a lawyer or HR expert for specific guidance. Learn about HR for Health's HR services.