Understanding the Affordable Care Act

Commonly referred to as the Affordable Care Act, or ACA, P.L. 111-148, the Patient Protection and Affordable Care Act, was signed into law in 2010.  Pete supported the Affordable Care Act because he believes that it will improve the quality and security of health insurance for individuals fortunate enough to already have coverage, while increasing access for the 14.5 percent of Northwest Indiana residents who do not.

Whatever your thoughts are on the law, Pete wants to help ensure that individuals and families across Northwest Indiana understand the Affordable Care Act so that you can be better equipped to take advantage of the new opportunities it provides. 

The Affordable Care Act and You

For an overview of how the Affordable Care Act works, view the below informative video created by the nonpartisan Kaiser Family Foundation, which explains the law’s provisions.



How the Law Protects You

Whether you need health coverage or have it already, the health care law offers new rights and protections.

• Creates the Health Insurance Marketplace, a new way families and individuals to compare and purchase health insurance.
• Provides subsidies to help eligible families and individuals purchasing plans on the Marketplace better afford the full price of premiums.
• Prohibits insurance companies from discriminating against or denying coverage to people with pre-existing health conditions.
• Makes it illegal for health insurance companies to arbitrarily cancel  your health insurance just because you get sick.
• Helps millions of seniors better afford prescription medication by closing the Medicare Part D “Donut Hole.”
• Allows young adults to stay on their parent’s health plans until age 26.
• Helps you understand the coverage you’re getting.
• Ensures that insurance companies spend more of the money you pay in premiums towards your health care, instead of administrative costs.
• Holds insurance companies accountable for rate increases.
• Provides free preventive care.
• Ends lifetime and annual dollar limits on coverage of essential health benefits.

For more information on how the law is helping Hoosiers, click here.

The Indiana Health Insurance Marketplace

The Health Insurance Marketplace is a new website where individuals can comparison shop for health insurance coverage.  Obtaining coverage through this website is NOT required.  Rather, it affords a new opportunity to make apples-to-apples comparisons of insurance options based on premiums, benefits, and other features important to you, and receive federal subsidies to help pay for coverage. 

When you apply for coverage in the Health Insurance Marketplace, you will need to provide some information about you and your household.  

When you are ready, there are three ways to enroll in a plan.
• You can sign up online by visiting www.healthcare.gov
• You can sign up by phone by calling 1-800-318-2596 for 24/7 assistance.
• You can receive in person assistance by contacting one of the many Navigators that are trained and certified to assist you locally.  

Many individuals and families will qualify for subsidies to help them purchase insurance coverage in the Marketplace.  The Kaiser Family Foundation has created a “Subsidy Calculator” to help people estimate their eligibility for subsidies and how much you could spend on health insurance.  You can visit this site here.

Unless you qualify for a Special Enrollment Period, you can only enroll in a health plan on the Marketplace during one of the designated Open Enrollment Periods.  For coverage starting in 2015, the proposed Open Enrollment Period is November 15, 2014, through February 15, 2015.  In the interim, you can look at sample plans and plan cost estimates in your area by visiting here.

Should you need specific assistance determining your options or obtaining coverage, you can always contact Pete’s Merrillville District office.


Understanding Your Options


Plans in the Marketplace are divided into categories  – bronze, silver, and gold – based on the level of coverage and cost sharing you can expect.

Determining what plan is right for you  will depend on your own health needs, balancing monthly premiums with anticipated out-of-pocket-costs. 


Seniors and the Affordable Care Act: Improving Medicare

Seniors on Medicare can keep their current Medicare coverage and do not need to make any changes to their coverage to comply with the law.

The Affordable Care Act contains several provisions to reduce costs and improve care for seniors enrolled in Medicare.
• Reduces prescription drug costs for seniors by closing the Medicare Part D “Donut Hole.”
• In order to encourage Medicare patients to use preventive services, the law eliminates co-pays and co-insurance for preventive and screening services, such as mammograms and colonoscopies.  Before the law was enacted, these services required co-pays as high as $160.
• Provides free Annual Wellness Visits.
• Helps secure Medicare for future generations by extending the solvency of the Medicare Trust Fund by 8 years.  The law accomplishes this without reducing payments to beneficiaries and instead eliminates waste.

Looking Forward

Pete believes that continued focus on repealing the Affordable Care Act will only eliminate the many benefits that the law provides.  It is time to turn our attention to improving and modifying the law, in a bipartisan fashion. 

Pete has already supported legislation that would improve some aspects of the law.  For example, in the 112th Congress, Pete supported P.L. 112-9, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, which repealed a reporting requirement for businesses because it would be unreasonably burdensome for small businesses. 

If you have thoughts on how you think the law can be improved, contact Pete and let him know how he can help.