Why Is Health Insurance Coverage Mandatory?


Quick Answer

Health insurance became mandatory in the United States when the Patient Protection and Affordable Care Act, or PPACA, also known as Obamacare, became law under President Barack Obama in June 2012. It went into effect on January 1, 2014, requiring all citizens to have health insurance coverage either from their employers or through government-sponsored health care programs supplied by the state or federal healthcare exchange program.

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Why Is Health Insurance Coverage Mandatory?
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Full Answer

The PPACA offers health plans to individual citizens and groups through the government sponsored Health Insurance Marketplace called exchanges.

There are five categories of Marketplace insurance plans: Bronze, Silver, Gold, Platinum and Catastrophic.

Depending on the plan, some allow the buyer to see any doctor or use any health care facility. Others limit the choices to a network of doctors and facilities or require the buyer to pay more if using a supplier outside of the network.

All plans are required to supply a package of items and services called essential health benefits. These essential benefits are required to include the following 10 categories:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care
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