Facts of ACA in Oregon

The Affordable Care Act (ACA) has made health coverage possible for thousands of Oregonians, and now 95 percent have coverage. More than 1.1 million people are insured through the Oregon Health Plan or private insurance offered through the Oregon Health Insurance Marketplace.

Oregonians who receive federal subsidies, get an average of $349 per month. This is to help cover the cost of private insurance purchased through the Health Insurance Marketplace. More than 375,000 Oregonians have enrolled in the Oregon Health Plan as part of the Medicaid expansion. We gained 23,300 health care jobs since the ACA in Oregon was implemented. The Economic Policy Institute estimates Oregon would lose approximately 42,000 jobs if the Affordable Care Act is repealed.

Besides providing access to coverage, the Affordable Care Act included other reforms to protect enrollees as well as funding for public health programs.

The ACA in Oregon also :

• Allows adult children to remain on their parents’ plan until age 26.
• Guarantees coverage despite pre-existing conditions.
• Requires restaurants and fast-food chains to provide meal calorie content information.
• Created prescription drug discounts for seniors who reach the coverage gap.
• And funded vital public health programs, such as teen suicide prevention, immunization, and tobacco use prevention.

CONSUMER PROTECTION

Affordable Care Act consumer protections apply to Oregonians who buy individual plans, both through the Health Insurance Marketplace and directly from an insurance carrier.

They include the following:

• Protections for Oregonians with pre-existing conditions: The ACA protects more than 1.6 million Oregonians who have pre-existing medical conditions from being denied with coverage or charged higher premiums by insurers.
• Lifetime and annual limits : The ACA made it illegal for insurance companies to place dollar limits on how much they will pay for essential health benefits.
• Mandated contraceptive coverage: Subject to limited exceptions for religious employers, commercial insurers must cover birth control and reproductive health services, including office visits without charging a co-payment or co-insurance.
• Free preventive care: The ACA requires insurance companies to provide dozens of these preventive services without charging a co-pay or co-insurance.
• The 80/20 rule: To help bring down premium costs, the ACA requires that at least 80 cents of every premium dollar collected be spent on patient benefits and care improvements.
• ACA prohibits discrimination: Today, insurers cannot discriminate based on a person’s race, color, national origin, sex, gender identity, age, or disability.