Patient Protection and Affordable Care Act
(ACA): Resources for Frequently Asked
Questions

Angela Napili
Information Research Specialist
October 20, 2015
Congressional Research Service
7-5700
www.crs.gov
R43215


Patient Protection and Affordable Care Act (ACA)

Summary
The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) has numerous
provisions affecting private health insurance and public health coverage programs. This report
provides resources to help congressional staff respond to constituents’ frequently asked questions
(FAQs) about the law. The report lists selected resources regarding consumers, employers, and
other stakeholders, with a focus on federal sources. It also lists CRS reports that summarize the
ACA’s provisions.
The report begins with links to contacts for specific ACA questions, such as consumer assistance
programs, state agencies, and local organizations that can answer constituents’ questions directly.
For example, the federal HealthCare.gov website has a consumer telephone hotline for questions
on exchange (marketplace) coverage, the Internal Revenue Service (IRS) has individual and
employer hotlines for tax-related questions (e.g., about premium tax credits), and the U.S.
Department of Labor has a consumer hotline for questions on employer-based coverage. The
report also lists sources for congressional staff to contact federal agencies with ACA questions.
The report provides basic consumer sources, including a glossary of health coverage terms. The
next sections focus on health coverage: the individual mandate, private health insurance, and
exchanges, as well as public health care programs, such as Medicaid and the State Children’s
Health Insurance Program (CHIP), Medicare, Indian health care, and veterans’ and military health
care. It then lists sources on employer-sponsored coverage, including sources on employer
penalties, small businesses, federal workers’ health plans, and union health plans. It also provides
sources on the ACA’s provisions on mental health, women’s health, public health, workforce,
quality, and taxes. Finally, the report lists sources on ACA costs and appropriations, insurance
coverage statistics, legal issues, the treatment of noncitizens under the ACA, and sources for
obtaining the law’s full text.
This list is not a comprehensive directory of all resources on the ACA but rather is intended to
address a few questions that may arise frequently.
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Patient Protection and Affordable Care Act (ACA)

Contents
Contacts for ACA Assistance........................................................................................................... 1
Contacts for Constituents .......................................................................................................... 1
Contacts for Congressional Staff ............................................................................................... 2
Basic Consumer Sources ................................................................................................................. 2
The Individual Mandate .................................................................................................................. 3
Private Health Insurance.................................................................................................................. 3
Exchanges and Subsidies ................................................................................................................. 5
Exchange Coverage ................................................................................................................... 5
Subsidies ................................................................................................................................... 6
Enrollment Reports ................................................................................................................... 7
Medicaid and the State Children’s Health Insurance Program ........................................................ 8
Medicare .......................................................................................................................................... 9
Indian Health Care ........................................................................................................................... 9
Veterans and Military Health Care ................................................................................................ 10
Employer-Sponsored Coverage ..................................................................................................... 10
Sources for Employees and Their Families ............................................................................. 10
Sources for Employers ............................................................................................................ 10
Employer Penalties ........................................................................................................................ 12
Small Businesses ........................................................................................................................... 12
Federal Employee Health Benefits Program ................................................................................. 13
Members of Congress and Congressional Staff ............................................................................ 14
Union Health Plans ........................................................................................................................ 14
Mental Health ................................................................................................................................ 15
Women’s Health ............................................................................................................................ 15
Public Health, Workforce, Quality, and Related Provisions .......................................................... 16
Taxes .............................................................................................................................................. 17
Tax Filing Resources ............................................................................................................... 17
Contacts for Tax Filing Assistance .......................................................................................... 18
Tax Provisions ......................................................................................................................... 18
Cost Estimates and Spending ........................................................................................................ 19
Statistics on Insurance Coverage ................................................................................................... 20
Legal Issues ................................................................................................................................... 21
Noncitizens .................................................................................................................................... 22
ACA Text ....................................................................................................................................... 22

Contacts
Author Contact Information .......................................................................................................... 23

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his report provides resources to help congressional staff respond to constituents’ frequently
asked questions (FAQs) about the Patient Protection and Affordable Care Act (ACA; P.L.
T 111-148, as amended). The report lists selected resources regarding consumers, employers,
and other stakeholders, with a focus on federal sources. It also lists Congressional Research
Service (CRS) reports that summarize the ACA’s provisions. The resources are arranged by topic.
This list is not a comprehensive directory of all resources on the ACA but rather is intended to
address a few questions that may arise frequently.
Contacts for ACA Assistance
Contacts for Constituents
Health plan enrollees may contact insurers directly to verify enrollment or to ask about coverage
of particular drugs, medical services, and health care providers. Enrollees can find their health
plan’s customer service phone number on their insurance card, on the insurer’s website, or by
calling the HealthCare.gov hotline (1-800-318-2596).
Contact Us (U.S. Department of Health and Human Services, HealthCare.gov)
https://www.healthcare.gov/contact-us/
The federal HealthCare.gov website offers a 24/7 consumer hotline (1-800-318-2596). For
translation assistance in other languages, constituents may also call the HealthCare.gov
hotline or visit the website at https://www.healthcare.gov/language-resource.
Find Local Help (U.S. Department of Health and Human Services, HealthCare.gov)
https://localhelp.healthcare.gov
A directory of state and local organizations trained to provide enrollment assistance and help
constituents understand their health coverage options. The directory includes navigators,
application assisters, certified application counselors, state and local government agencies,
and agents and brokers.
Consumer Assistance Program (The Center for Consumer Information and Insurance Oversight)
https://www.cms.gov/CCIIO/Resources/Consumer-Assistance-Grants/
A directory of consumer assistance programs and other state agencies that can answer
constituent questions on ACA and health insurance.
Consumer Assistance (U.S. Department of Labor, Employee Benefits Security Administration)
https://www.dol.gov/ebsa/contactEBSA/consumerassistance.html
Constituents with questions about employer-based health coverage can speak with benefits
advisors at 1-866-444-3272.
Telephone Assistance (Internal Revenue Service)
http://www.irs.gov/uac/Telephone-Assistance
The IRS is implementing many of the ACA’s tax provisions, including the individual
mandate, premium tax credits, and employer shared responsibility penalties. The Internal
Revenue Service (IRS) has a Healthcare Hotline for ACA questions (800-919-0452) and other
telephone hotlines to answer questions from individuals and employers.
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Contacts for Congressional Staff
Congressional Marketplace Hotline (U.S. Department of Health and Human Services, Centers for
Medicare and Medicaid Services)
A dedicated hotline exclusively for Members of Congress and congressional staff with
questions about ACA implementation and exchanges: 202-690-8004,
MarketplaceHillQuestions@cms.hhs.gov.
CRS Report 98-446, Congressional Liaison Offices of Selected Federal Agencies
This CRS report lists congressional liaison offices at federal agencies, including those that
work on ACA issues, such as the IRS, the Department of Labor, and the Congressional
Budget Office. Congressional liaison offices can answer questions from Members of
Congress and congressional staff; they usually do not assist constituents directly.
CRS reports on ACA are at CRS.gov: Issues Before Congress: Health Care Reform
http://www.crs.gov/Cli/SubIssue?cliId=3746&itemType=Ibc&preview=False&topCat=Health&
topCatId=13
Each report has author contact information. CRS authors are available to answer questions
from Members of Congress and congressional staff. CRS provides research and analysis
exclusively to Congress, and CRS authors are unable to assist constituents directly.
Basic Consumer Sources
HealthCare.gov (U.S. Department of Health and Human Services)
http://www.healthcare.gov
The official federal portal for ACA consumer information. Questions and answers on health
insurance under ACA, including options for obtaining coverage. Click “Get Answers” for
sources tailored to specific populations, such as young adults, self-employed people,
unemployed people, people with disabilities, veterans, American Indians and Alaska Natives,
pregnant women, same-sex married couples, retirees, and incarcerated people. A Spanish-
language version is at http://www.CuidadoDeSalud.gov.
Affordable Care Act Tax Provisions for Individuals and Families (Internal Revenue Service)
http://www.irs.gov/Affordable-Care-Act/Individuals-and-Families
Explanations of ACA tax provisions for consumers, including provisions on premium tax
credits, the individual mandate (sometimes called the “individual shared responsibility”
provision), and other tax provisions. FAQs are at http://www.irs.gov/uac/Newsroom/
Affordable-Care-Act-Tax-Provisions-Questions-and-Answers.
Glossary (U.S. Department of Health and Human Services, HealthCare.gov)
http://www.healthcare.gov/glossary/index.html
Plain-language definitions of health care and health insurance terms.
From Coverage to Care (Centers for Medicare and Medicaid Services)
http://marketplace.cms.gov/technical-assistance-resources/c2c.html
For consumers with new health coverage, the resource “A Roadmap to Better Care and a
Healthier You” and a series of videos explain how to read an insurance card, how to choose a
provider, how to set up and prepare for a health care appointment, and more.

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CRS Report RL32237, Health Insurance: A Primer
A basic policy overview of health insurance: key definitions and principles, the regulation of
health insurance, and sources of health insurance.
CRS Report R44100, Use of the Annual Appropriations Process to Block Implementation of the
Affordable Care Act (FY2011-FY2016)

Includes “A Brief Overview of the ACA.”
The Individual Mandate
Questions and Answers on the Individual Shared Responsibility Provision (Internal Revenue
Service)
http://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Questions-and-Answers-on-
the-Individual-Shared-Responsibility-Provision
Basic background on the individual mandate, the requirement that most individuals have
minimum essential health coverage or else pay a tax penalty. Describes what counts as
minimum essential coverage, who is subject to the mandate, and how the mandate is
enforced.
CRS Report R41331, Individual Mandate Under the ACA
The following is an excerpt from the report:
Since 2014, the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as
amended) has required most individuals to maintain health insurance coverage or
potentially to pay a penalty for noncompliance. Specifically, most individuals are
required to maintain minimum essential coverage for themselves and their dependents.
Minimum essential coverage is a term defined in the ACA and its implementing
regulations and includes most private and public coverage (e.g., employer-sponsored
coverage, individual coverage, Medicare, and Medicaid, among others). Some individuals
are exempt from the mandate and the penalty, and others may receive financial assistance
to help them pay for the cost of health insurance coverage and the costs associated with
using health care services.
Fees & Exemptions (U.S. Department of Health and Human Services, HealthCare.gov)
https://www.healthcare.gov/fees-exemptions/
Details on the individual mandate penalty. Lists examples of circumstances that could warrant
an individual mandate exemption. Links to application forms for exemptions based on
coverage being unaffordable; certain hardship, tribal, incarceration, and religious exemptions;
and exemptions based on membership in a health care sharing ministry.
Private Health Insurance
See also “Exchanges and Subsidies” and “Employer-Sponsored Coverage.”
CRS Report R42069, Private Health Insurance Market Reforms in the Affordable Care Act (ACA)
Table A-1 shows which private health insurance market reforms apply to which health plans,
depending on whether the plans are grandfathered; whether they are sold in the large-group,
small-group, or individual market; and whether group plans are fully insured or self-insured.
CRS Report R43854, Overview of Private Health Insurance Provisions in the Patient Protection
and Affordable Care Act (ACA)

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An excerpt from the report appears below:
Private health insurance (PHI) is the predominate form of health insurance coverage in
the United States, covering about two-thirds of Americans in 2013. The Patient
Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) builds on existing
sources of private health insurance coverage—the nongroup (individual), small group,
and large group markets. The ACA private health insurance provisions follow a federalist
model in which they establish federal minimum requirements and give states the
authority to enforce and expand those federal standards.
Health coverage rights and protections (U.S. Department of Health and Human Services,
HealthCare.gov)
https://www.healthcare.gov/health-care-law-protections/
Summarizes consumer protections under ACA, such as coverage for pre-existing conditions,
the requirement that insurers provide a plain-language Summary of Benefits and Coverage,
and restrictions on lifetime and annual limits.
Fact Sheets and Frequently Asked Questions (FAQs) (The Center for Consumer Information and
Insurance Oversight)
http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/index.html
The federal Center for Consumer Information and Insurance Oversight is charged with
implementing the ACA’s private health insurance reforms. This page provides information for
stakeholders, including state officials, health insurance companies, and consumers.
Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on
Businesses and Families
(Employee Benefits Security Administration)
http://www.dol.gov/ebsa/faqs/faq-dependentcoverage.html
Questions and answers on the ACA’s dependent coverage provision. Under the ACA, if a
health plan provides for dependent coverage of children, the plan must make such coverage
available for adult children under the age of 26. This requirement became effective for plan
years beginning on or after September 23, 2010.
CRS Report R44014, An Introduction to Health Insurance: What Should a Consumer Know?
The following is an excerpt from the report:
This report provides an overview of private-sector (as opposed to government-provided)
health insurance. It serves as an introduction to health insurance from the point of view of
many consumers under the age of 65. No background in health insurance is assumed, and
all terms are defined in the body of the report.
CRS Report R44163, The Patient Protection and Affordable Care Act’s Essential Health Benefits
(EHB)

The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended)
requires all non-grandfathered health plans in the non-group and small-group private
health insurance markets to offer a core package of health care services, known as the
essential health benefits (EHB). The ACA does not specifically define this core package
but rather lists 10 benefit categories from which benefits and services must be included.
CRS Insight IN10128, From Initial Rate Filings to Final Premiums: Peering into the Black Box
Brief overview of the process that insurers and regulators use to develop, review, and finalize
premiums.
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ACA Title I Provisions to be Implemented or Terminated in 2015 (CRS Memorandum, November
17, 2014, available to congressional staff upon request)
According to the memorandum,
one of the core objectives of the Patient Protection and Affordable Care Act (ACA, P.L.
111-148, as amended) is to expand health insurance coverage. Many of the coverage
expansion provisions emphasize increasing access to private health insurance (Title I of
ACA)… This memorandum provides a broad overview of Title I provisions that either
will be implemented or terminated sometime in 2015.
CRS Insight IN10362, A Framework for Understanding Health Insurance Consolidations
An excerpt appears below:
Insofar as insurers operate in a more heavily regulated industry, the ACA may be playing
a role in the continuing trend in M&A [mergers and acquisitions]. However, the history
of insurer consolidations long precedes ACA enactment. And the impact of the ACA has
not been fully realized. Some of the ACA's provisions came into effect just last year,
while other provisions have yet to be completely implemented.
Exchanges and Subsidies
Exchange Coverage
Get Coverage (U.S. Department of Health and Human Services, HealthCare.gov)
https://www.healthcare.gov/get-coverage-topic/
Under the ACA, exchanges (sometimes called marketplaces) have been established to provide
eligible individuals with access to private health insurance plans. The 2016 open season is
November 1, 2015, to January 31, 2016. Some people may qualify to get coverage outside of
open season. This website has plain-language information about the exchanges. For a briefer
overview, see “A quick guide to the Health Insurance Marketplace,”
https://www.healthcare.gov/quick-guide/. For information about the exchange in a specific
state, choose the state from the pull-down menu at https://www.healthcare.gov/get-coverage/.
Getting health coverage outside Open Enrollment (U.S. Department of Health and Human
Services, HealthCare.gov)
https://www.healthcare.gov/coverage-outside-open-enrollment/
This document lists examples of “qualifying life events” that could make individuals eligible
for “special enrollment periods” outside of open season. (Examples of qualifying life events
include income changes, marriage, birth, adoption, moving to a new area, and losing other
health coverage.) The 2015 open season was November 15, 2014, to February 15, 2015. The
2016 open season is November 1, 2015, to January 31, 2016. Individuals can apply for
Medicaid or State Children’s Health Insurance Program (CHIP) coverage any time.
Reporting life & income changes to the Marketplace (U.S. Department of Health and Human
Services, HealthCare.gov)
https://www.healthcare.gov/reporting-changes/
For persons with exchange coverage, instructions for reporting changes in income, health
coverage eligibility (e.g., an offer of job-based coverage), and household members (e.g.,
marriage, birth, adoption). These changes could affect subsidy amounts and eligibility for
coverage.
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Browse coverage options (U.S. Department of Health and Human Services, HealthCare.gov)
https://www.healthcare.gov/see-plans/
For federally facilitated exchanges, this website lets consumers view plan information and
premium estimates without opening a HealthCare.gov account.
What plans cover (U.S. Department of Health and Human Services, HealthCare.gov)
https://www.healthcare.gov/coverage/
Lists the “essential health benefits” that exchange plans are required to cover. Specific benefit
details differ by state and by plan.
Health Insurance Marketplace (Centers for Medicare and Medicaid Services)
http://marketplace.cms.gov/
For professionals assisting consumers with enrollment, this site has technical assistance
resources, applications and forms, and federal education and outreach materials. Some of the
resources are available in Spanish and selected other languages.
Using Your Marketplace Health Coverage (U.S. Department of Health and Human Services,
HealthCare.gov)
https://www.healthcare.gov/using-marketplace-coverage/
Consumer tips for verifying enrollment, getting prescription drugs, finding a doctor, getting
emergency care, and appealing insurance-company decisions.
CRS Report R44065, Overview of Health Insurance Exchanges
An excerpt from the report appears below:
This report provides an overview of the various components of the health insurance
exchanges. The report includes summary information about how exchanges are
structured, the intended consumers for health insurance exchange plans, and consumer
assistance available in the exchanges, as specified in the ACA. The report also describes
the availability of financial assistance for certain exchange consumers and small
businesses and outlines the range of plans offered through exchanges. Moreover, the
report provides a brief summary of the implementation and operation of exchanges in
2014 and 2015.
Subsidies
CRS Report R43945, Health Insurance Premium Credits in the Patient Protection and Affordable
Care Act (ACA) in 2015

To make exchange coverage more affordable, the federal government subsidizes premium
costs for certain individuals through “premium credits,” a type of federal tax credit. An
individual may be eligible for a premium tax credit if his or her household income is between
100% and 400% of the federal poverty level and he or she does not have access to affordable
health coverage through another source, such as an employer.
Getting Lower Costs (U.S. Department of Health and Human Services, HealthCare.gov)
https://www.healthcare.gov/lower-costs/
Information on available subsidies for health coverage, including premium credits and cost-
sharing subsidies.
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The Premium Tax Credit (Internal Revenue Service)
http://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/The-Premium-Tax-Credit
Basic background on premium credits. FAQs are at Questions and Answers on the Premium
Tax Credit
http://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Questions-and-
Answers-on-the-Premium-Tax-Credit.
Enrollment Reports
Affordable Care Act Research (U.S. Department of Health and Human Services, Office of the
Assistant Secretary for Planning and Evaluation)
http://aspe.hhs.gov/affordable-care-act-research
Includes monthly enrollment reports from the 2015 and 2014 open seasons for ACA health
insurance exchanges. The 2015 summary report is Health Insurance Marketplace 2015 Open
Enrollment Period: March Enrollment Report
(March 2015) http://aspe.hhs.gov/pdf-
document/health-insurance-marketplace-2015-open-enrollment-period-march-enrollment-
report. The 2014 summary report is Health Insurance Marketplace: Summary Enrollment
Report for the Initial Annual Open Enrollment Period
(May 2014) http://aspe.hhs.gov/pdf-
report/health-insurance-marketplace-summary-enrollment-report-initial-annual-open-
enrollment-period-0.
June 30, 2015 Effectuated Enrollment Snapshot (Centers for Medicare & Medicaid Services,
September 8, 2015)
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-
items/2015-09-08.html
This fact sheet includes state tables. The following is an excerpt:
On June 30, 2015, about 9.9 million consumers had effectuated Health Insurance
Marketplace coverage – which means those individuals paid their premiums and had an
active policy at the end of June... Of the approximately 9.9 million consumers nationwide
with effectuated Marketplace enrollments at the end of June 2015, about 84 percent, or
more than 8.3 million consumers, were receiving an advanced premium tax credit
(APTC) to make their premiums more affordable throughout the year. The average APTC
for those enrollees who qualified for the financial assistance was $270 per month.
2015 Special Enrollment Period Report – February 23–June 30, 2015 (Centers for Medicare &
Medicaid Services, August 13, 2015)
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/
2015-08-13.html
The 2015 open season ended in February 2015, but certain qualifying life events make some
individuals eligible for “special enrollment periods” outside of open season. This fact sheet
has data on the 944,000 consumers who made plan selections through HealthCare.gov using a
special enrollment period. The data are for the 37 states using the HealthCare.gov platform,
from February 23 through June 30, 2015.
CRS Insight IN10282, Maps of 2015 Individual Exchange Enrollment by Zip Code
An excerpt from the report appears below:
This Insight presents a tool to examine exchange enrollment information by zip code with
additional geographic boundaries. Table 1 presents data on exchange enrollment for all
states and includes hyperlinks to maps of exchange enrollment by zip code for 37 states.
Each map includes an option to overlay county and congressional district boundaries. The
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maps are not an aggregation of exchange enrollment by county or congressional district;
rather, the maps present optional geographical boundaries over exchange enrollment by
zip code.
2015 Plan Selections by County in the Health Insurance Marketplace (U.S. Department of Health
and Human Services, Office of the Assistant Secretary for Planning and Evaluation, July 2015)
http://aspe.hhs.gov/basic-report/2015-plan-selections-county-health-insurance-marketplace
This spreadsheet has county-level data on exchange plan selections, including demographic
data (such as income, age, and race), plan metal levels, advanced premium tax credits
(APTC), and cost-sharing reductions (CSR). The data are for November 15, 2014, through
February 22, 2015, in the 37 states that used the HealthCare.gov platform.
Medicaid and the State Children’s Health Insurance
Program
Individuals can enroll in Medicaid and the State Children’s Health Insurance Program (CHIP) any
time of the year. There is no limited enrollment period for these programs.
Each state operates its own Medicaid and CHIP programs within federal guidelines.
 Links to each state’s Medicaid website and program information:
http://medicaid.gov/Medicaid-CHIP-Program-Information/By-State/By-
State.html
 Links to each state’s CHIP website:
http://insurekidsnow.gov/state/index.html
Medicaid and CHIP coverage (U.S. Department of Health and Human Services, HealthCare.gov)
https://www.healthcare.gov/medicaid-chip/
FAQs and tips for Medicaid and CHIP potential applicants and new enrollees.
CRS Report R43564, The ACA Medicaid Expansion
The following is an excerpt from the report:
Historically, Medicaid eligibility has generally been limited to certain low-income
children, pregnant women, parents of dependent children, the elderly, and individuals
with disabilities; however, as of January 1, 2014, states have the option to extend
Medicaid coverage to most nonelderly, low-income individuals.
Affordable Care Act (Centers for Medicare and Medicaid Services, Medicaid.gov)
http://www.medicaid.gov/AffordableCareAct/Affordable-Care-Act.html
Summaries of major ACA provisions related to Medicaid and CHIP.
CRS Report R41210, Medicaid and the State Children’s Health Insurance Program (CHIP)
Provisions in ACA: Summary and Timeline

Detailed section-by-section summary of ACA’s Medicaid and CHIP provisions.
Frequently Asked Questions: Affordable Care Act (Centers for Medicare and Medicaid Services,
Medicaid.gov)
https://questions.medicaid.gov/faq.php?id=5010&rtopic=2040
For state officials and stakeholders, these sources address questions on the ACA, Medicaid,
and CHIP.
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Medicare
Medicare.gov (Centers for Medicare and Medicaid Services)
https://www.medicare.gov/
Official federal portal for consumer information on Medicare. See “Find someone to talk to”
for a directory of consumer assistance contacts, including State Health Insurance Assistance
Programs (SHIPs) that offer personalized health insurance counseling for Medicare
beneficiaries.
Medicare and the Health Insurance Marketplace (Centers for Medicare and Medicaid Services)
http://medicare.gov/Pubs/pdf/11694.pdf
Consumer FAQs about the relationship between Medicare and the ACA exchanges
(marketplaces). Questions include “Can I get a Marketplace plan in addition to Medicare?”
and “What if I become eligible for Medicare after I join a Marketplace plan?”
Medicare and the Marketplace (Centers for Medicare and Medicaid Services)
http://www.cms.gov/Medicare/Eligibility-and-Enrollment/Medicare-and-the-Marketplace/
Overview1.html
FAQs about the relationship between Medicare and the ACA exchanges (marketplaces),
including questions on enrollment, coordination of benefits, and end-stage renal disease.
Medicare and the Marketplace (U.S. Department of Health and Human Services,
HealthCare.gov)
https://www.healthcare.gov/medicare/medicare-and-the-marketplace/
Information on how the ACA affects Medicare beneficiaries, and how to switch from
exchange coverage to Medicare.
CRS Report R41196, Medicare Provisions in the Patient Protection and Affordable Care Act
(PPACA): Summary and Timeline

Detailed section-by-section summary of the ACA’s Medicare provisions.
CRS Report R44075, The Independent Payment Advisory Board (IPAB): Frequently Asked
Questions

FAQs on the Independent Payment Advisory Board, which ACA established to develop
proposals to “reduce the per capita rate of growth in Medicare spending.”

Indian Health Care
CRS Report R41152, Indian Health Care: Impact of the Affordable Care Act (ACA)
The ACA reauthorized the Indian Health Care Improvement Act (IHCIA), which authorizes
many Indian Health Service programs and services. This report summarizes major IHCIA
changes and other ACA provisions that may affect American Indian and Alaska Native health
care.
CRS Report R41630, The Indian Health Care Improvement Act Reauthorization and Extension as
Enacted by the ACA: Detailed Summary and Timeline

Detailed section-by-section summary of IHCIA provisions in the ACA.
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Affordable Care Act (Indian Health Service)
http://www.ihs.gov/ACA/
Includes FAQs on the ACA for Indian Health Service-eligible persons.
Veterans and Military Health Care
The Affordable Care Act, VA, and You: Frequently Asked Questions (U.S. Department of Veterans
Affairs)
http://www.va.gov/health/aca/FAQ.asp
Answers to veterans’ FAQs about the ACA. The website notes that “the health care law does
not change VA health benefits or Veterans’ out-of-pocket costs.”
TRICARE and the Affordable Care Act (Defense Health Agency)
http://tricare.mil/aca
Explains that the military’s TRICARE health program is considered minimum essential
coverage for the purpose of ACA’s individual mandate.
Employer-Sponsored Coverage
See also “Employer Penalties,” “Small Businesses,” “Federal Employee Health Benefits
Program,
and “Taxes.”
Sources for Employees and Their Families
People with coverage through a job (U.S. Department of Health and Human Services,
HealthCare.gov)
https://www.healthcare.gov/have-job-based-coverage/
FAQs for consumers with employer-sponsored coverage and those who are losing their
employer-sponsored coverage.
Consumer Information on the Affordable Care Act (U.S. Department of Labor, Employee Benefits
Security Administration)
http://www.dol.gov/ebsa/healthreform/consumer.html
For employees who receive health coverage through their jobs, this page lists consumer
protections under the ACA, such as coverage of pre-existing conditions and preventive
services; and the requirement that employees receive a plain-language Summary of Benefits
and Coverage.
Consumer Assistance (U.S. Department of Labor, Employee Benefits Security Administration)
https://www.dol.gov/ebsa/contactEBSA/consumerassistance.html
Constituents with questions about employer-based health coverage can speak with benefits
advisors at 1-866-444-3272.
Sources for Employers
Affordable Care Act (U.S. Department of Labor, Employee Benefits Security Administration)
http://www.dol.gov/ebsa/healthreform/
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Information on ACA implementation for employers. This page has information on
grandfathered plans, waiting periods, and other topics for employer-sponsored health
coverage.
Affordable Care Act: What employers need to know (Internal Revenue Service)
http://www.irs.gov/pub/irs-pdf/p5200.pdf
One-page overview of ACA information reporting requirements, employer shared
responsibility provisions, SHOP eligibility, and the small business health care tax credit.
Understanding employer reporting requirements of the health care law (Internal Revenue
Service)
http://www.irs.gov/pub/irs-pdf/p5196.pdf
Two-page brochure on ACA information reporting requirements for applicable large
employers.
Are you an applicable large employer? (Internal Revenue Service)
http://www.irs.gov/pub/irs-pdf/p5208.pdf
One-pager explains how to determine whether an organization is an applicable large
employer. Applicable large employers are subject to ACA information reporting and
employer shared responsibility provisions.
Affordable Care Act Tax Provisions for Employers (Internal Revenue Service)
http://www.irs.gov/Affordable-Care-Act/Employers
Explanations of ACA tax provisions for employers, such as W-2 reporting requirements, the
Small Business Health Care Tax Credit, and potential employer penalties for certain large
employers.
Affordable Care Act: Responsibilities for Health Coverage Providers: Understanding reporting
requirements of the health care law
(Internal Revenue Service)
http://www.irs.gov/pub/irs-pdf/f5215.pdf
Two-page overview of reporting requirements for entities that provide minimum essential
coverage. The requirement applies to certain plan sponsors of self-insured group health plan
coverage.
CRS Report R44147, Excise Tax on High-Cost Employer-Sponsored Health Coverage: In Brief
The ACA includes a 40% tax on employer-sponsored health coverage. The tax applies to the
aggregate cost of applicable coverage that exceeds a specified dollar limit. Sometimes called
the “Cadillac tax,” this tax will be implemented beginning in 2018.
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Employer Penalties
Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care
Act
(Internal Revenue Service)
http://www.irs.gov/Affordable-Care-Act/Employers/Questions-and-Answers-on-Employer-
Shared-Responsibility-Provisions-Under-the-Affordable-Care-Act
FAQs on the employer shared responsibility provisions under the ACA. This document
describes which employers are subject to the penalty and how the penalty amount is
calculated, and it provides important dates.
CRS Report R43981, The Affordable Care Act’s (ACA) Employer Shared Responsibility
Determination and the Potential ACA Employer Penalty

ACA’s “shared responsibility” provision imposes penalties on certain large employers (with
at least 50 full-time equivalent workers) if they do not offer “affordable” health coverage to
employees and at least one of their full-time employees obtains a premium credit (subsidy)
through the exchanges. This report describes the process for determining which employers
are subject to the provision and describes penalty calculations. It also describes ACA’s other
employer provisions, such as reporting requirements, the dependent coverage provision, and
provisions on “affordable” and “adequate” health coverage.
CRS Report R43181, The Affordable Care Act and Small Business: Economic Issues
Includes analysis of ACA employer penalties.
CRS In Focus IF10039, Proposals to Change the ACA’s Definition of “Full Time”
Analysis of proposals to change ACA’s definition of “full-time” from 30 hours to 40 hours a
week.
Small Businesses
Health Care (U.S. Small Business Administration)
http://www.sba.gov/healthcare
Articles explain ACA provisions for small businesses.
CRS Report R43771, Small Business Health Options Program (SHOP) Exchange
According to the report,
SHOP exchanges are marketplaces where private health insurance issuers sell health
insurance plans to small employers. All health plans available through SHOP exchanges
must meet certain federally required criteria, such as offering a standardized package of
benefits. Certain small employers may be eligible to receive tax credits toward the cost of
coverage if they obtain coverage through a SHOP exchange...
This report describes certain features of SHOP exchanges, such as employer eligibility,
methods for selecting health plans offered through SHOP exchanges, and how health
insurance agents and brokers interact with SHOP exchanges. Each description includes
information about how the feature is implemented in SHOP exchanges administered by
states and those administered in part or in entirety by HHS. Each description also
includes information about the timing of implementation. The report concludes with a
discussion about the current and future place of SHOP exchanges in the broader context
of the private health insurance market.
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Small Business: Get health insurance for your employees (U.S. Department of Health and Human
Services, HealthCare.gov)
https://www.healthcare.gov/small-businesses
FAQs about the SHOP exchange. For further questions, the federal health insurance call
center for small employers is 1-800-706-7893.
CRS Report R41158, Summary of the Small Business Health Insurance Tax Credit Under ACA
Under the ACA, the small business tax credit is available to qualifying for-profit and
nonprofit employers with fewer than 25 full-time equivalent employees with average annual
wages that fall under a statutorily specified cap. To qualify for the credit, employers must
cover at least 50% of the cost of each of their employees’ self-only health insurance coverage.
CRS Report R43181, The Affordable Care Act and Small Business: Economic Issues
Analysis of ACA employer penalties, the small business health insurance tax credit, and
SHOP exchanges.
CRS Insight IN10346, Health Insurance: Small is the New Large
An excerpt appears below:
The group health insurance market is divided into large- and small-group markets.
Historically, employers with 50 or fewer employees were considered small and could
purchase health insurance coverage in the small-group market. The Patient Protection and
Affordable Care Act (ACA; P.L. 111-148, as amended) expands the definition of small
employer to include employers with 100 or fewer employees. States must implement the
expanded definition for plan years beginning in 2016 and have the option of
implementing the expanded definition prior to 2016.
Federal Employee Health Benefits Program
CRS Report R42741, Laws Affecting the Federal Employees Health Benefits (FEHB) Program
Includes information about the ACA in the Appendix, under “Patient Protection and
Affordable Care Act (P.L. 111-148, as amended), March 23, 2010.”
The Affordable Care Act and OPM (U.S. Office of Personnel Management)
http://www.opm.gov/healthcare-insurance/affordable-care-act/
Includes ACA resources and FAQs on FEHBP.
Tribal Employers: Indian Tribes FAQs (U.S. Office of Personnel Management)
http://www.opm.gov/healthcare-insurance/tribal-employers/faqs/
FAQs on how the ACA expands eligibility for tribal employees under FEHBP.
Changes to Federal Benefits Eligibility Due to Health Reform: Frequently Asked Questions
(FAQs)
(U.S. Office of Personnel Management)
http://www.opm.gov/healthcare-insurance/special-initiatives/health-care-reform/
FAQs for federal employees on the ACA dependent coverage provision, which became
effective for plan years beginning on or after September 23, 2010.
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Members of Congress and Congressional Staff
CRS Report R43194, Health Benefits for Members of Congress and Designated Congressional
Staff

A provision in the ACA specifically affects Members of Congress and certain congressional
staff and their employer-sponsored health benefits. This report explains the implementation of
that provision.
The Affordable Care Act and OPM (U.S. Office of Personnel Management)
http://www.opm.gov/healthcare-insurance/affordable-care-act/
Includes ACA resources for Members of Congress and congressional staff.
I am an employee in the official office of a Member of Congress. How do I enroll in DC Health
Link
? (DC Health Link)
https://dchealthlink.com/node/1638
Members of Congress and designated congressional staff can purchase health insurance from
the District of Columbia SHOP exchange, called DC Health Link (855-532-5465). The web
page notes that questions can also be answered by the U.S. Senate Benefits Section (202-224-
1093) and the House of Representatives Office of Payroll and Benefits (202-225-1435). The
Open Enrollment period for 2016 coverage is November 9, 2015 to December 14, 2015.
Union Health Plans
Multiemployer Health Plans, the Taft-Hartley Act, and the Patient Protection and Affordable
Care Act (ACA)
(CRS Memorandum, June 26, 2013, available to congressional staff upon
request)
According to the memorandum,
Unions and multiemployer plan representatives have expressed an interest in allowing
union members and multiemployer plans to participate in the health insurance exchanges
established by the Patient Protection and Affordable Care Act (ACA, P.L. 111-148), as
amended. In light of this interest, this memorandum provides background information
about multiemployer plans, ACA, and another relevant federal statute, the Taft-Hartley
Act. The analysis considers two related scenarios: (1) an individual who is eligible for a
multiemployer health plan applying for a premium tax credit; and (2) a multiemployer
health plan being offered in a health insurance exchange.
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Mental Health
Health Insurance and Mental Health Services (U.S. Department of Health and Human Services,
MentalHealth.gov)
http://www.mentalhealth.gov/get-help/health-insurance/index.html
FAQs about private health insurance, Medicare, and Medicaid coverage of mental health
benefits.
Affordable Care Act Implementation FAQs - Set 17 (The Center for Consumer Information and
Insurance Oversight, November 8, 2013)
http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs17.html
FAQs about the implementation of the Mental Health Parity and Addiction Equity Act of
2008 (MHPAEA), as amended by the ACA. An excerpt appears below.
MHPAEA amended the Public Health Service Act (PHS Act), the Employee Retirement
Income Security Act (ERISA) and the Internal Revenue Code (the Code) to provide
increased parity between mental health and substance use disorder benefits and
medical/surgical benefits. In general, MHPAEA requires that the financial requirements
(such as coinsurance) and treatment limitations (such as visit limits) imposed on mental
health and substance use disorder benefits cannot be more restrictive than the
predominant financial requirements and treatment limitations that apply to substantially
all medical/surgical benefits.
What plans cover: Mental health & substance abuse coverage (U.S. Department of Health and
Human Services, HealthCare.gov)
https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/
Brief overview of requirements for behavioral health services coverage in exchange plans.
Affordable Care Act Expands Mental Health and Substance Use Disorder Benefits and Federal
Parity Protections for 62 Million Americans
(U.S. Department of Health and Human Services,
Office of the Assistant Secretary for Planning and Evaluation, February 20, 2013)
http://aspe.hhs.gov/report/affordable-care-act-expands-mental-health-and-substance-use-disorder-
benefits-and-federal-parity-protections-62-million-americans
Estimates of the impact of the MHPAEA, as amended by ACA.
Women’s Health
Women’s Preventive Services Guidelines (U.S. Department of Health and Human Services, Health
Resources and Services Administration)
http://www.hrsa.gov/womensguidelines/
Lists the women’s preventive services that non-grandfathered health plans generally are
required to cover without cost sharing.
CRS Report R44130, Federal Support for Reproductive Health Services: Frequently Asked
Questions

Discusses ACA requirements for coverage of reproductive health services.
CRS In Focus IF10169, The Affordable Care Act’s Contraceptive Coverage Requirement: History
of Regulations for Religious Objections

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The following is an excerpt from the report:
The Affordable Care Act (ACA; P.L. 111-148) requires that group health plans and
health insurance issuers provide coverage for certain preventive health services without
imposing any cost-sharing requirements. 42 U.S.C. §300gg-13(a)(4). The preventive
services covered include Food and Drug Administration (FDA)-approved contraceptive
methods, which generated controversy among employers who oppose the use of
contraception based on their religious beliefs. This requirement has been implemented
through a series of administrative regulations since 2010, when ACA was enacted.
CRS Report R43654, Free Exercise of Religion by Closely Held Corporations: Implications of
Burwell v. Hobby Lobby Stores, Inc.

Discusses the case’s effect on ACA contraceptive coverage requirements. For additional legal
analysis of contraceptive coverage requirements, see CRS Legal Sidebar: Freedom of
Religion http://www.crs.gov/LegalSidebar/Category/47.
Fact Sheet: Women’s Preventive Services Coverage, Non-Profit Religious Organizations, and
Closely-Held For-Profit Entities
(The Center for Consumer Information and Insurance Oversight)
http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/womens-preven-02012013.html
Under ACA, non-grandfathered health plans generally are required to cover contraceptives
without cost sharing. This page describes exemptions for religious employers (such as
churches) and accommodations for nonprofit religious organizations and certain closely held
for-profit entities.
Fact Sheets and Frequently Asked Questions (FAQs) (The Center for Consumer Information and
Insurance Oversight)
http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/index.html#AffordableCareAct
The section “Affordable Care Act” includes FAQs on women’s preventive services.
FAQ set 26 addresses BRCA testing, contraceptives, and well-woman preventive care for
dependents, http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/
aca_implementation_faqs26.pdf.
FAQ set 12 discusses well-woman visits; interpersonal and domestic violence screening;
Human Papillomavirus (HPV) DNA testing; HIV testing; and breastfeeding support, supplies,
and counseling, http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/
aca_implementation_faqs12.html.
Public Health, Workforce, Quality, and
Related Provisions
CRS Report R41278, Public Health, Workforce, Quality, and Related Provisions in ACA:
Summary and Timeline

Detailed section-by-section summary of the ACA’s provisions on public health, the health
workforce, quality improvement, health centers, prevention and wellness, maternal and child
health, nursing homes and other long-term care providers, comparative effectiveness
research, health information technology, emergency care, elder justice, biomedical research,
FDA and medical products, 340B drug pricing, and malpractice reform.
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link to page 6 link to page 9 Patient Protection and Affordable Care Act (ACA)

Taxes
See also “The Individual Mandate” and “Subsidies.”
Tax Filing Resources
The tax filing deadline was April 15, but the resources below may be helpful for late filers or
others seeking general information.
The Health Care Law and Your Taxes: What the Affordable Care Act (ACA) Means for Your 2014
Federal Tax Return
(Internal Revenue Service)
http://www.irs.gov/pub/irs-pdf/p5201.pdf
Infographics on the individual mandate and premium tax credits.
Health coverage and your federal income taxes (U.S. Department of Health and Human Services,
HealthCare.gov)
https://www.healthcare.gov/taxes/
For consumers, links to tips and tools for completing 2014 federal income tax returns.
Fact Sheet: Health Coverage and Federal Income Taxes (U.S. Department of Health and Human
Services)
http://www.hhs.gov/healthcare/facts/factsheets/2015/01/health-coverage-federal-income-
taxes.html
Federal income tax information for persons with non-exchange coverage for all of 2014,
persons with exchange coverage in 2014, and persons who did not have health coverage in
2014.
Forms and Publications (Internal Revenue Service)
http://www.irs.gov/Forms-&-Pubs
Federal tax forms and instructions relevant to the ACA. Form 8965 is for reporting a
coverage exemption from the individual mandate granted by an exchange and applying for an
individual mandate exemption. Form 8962 is for reconciling advance premium tax credits
received with the premium tax credits actually due.
Tax information (Centers for Medicare and Medicaid Services)
https://marketplace.cms.gov/technical-assistance-resources/tax-information.html
Tax fact sheets, infographics, and articles for professionals assisting consumers with
exchange coverage.
Free File: Do Your Federal Taxes for Free (Internal Revenue Service)
http://irs.gov/FreeFile
Fillable electronic forms for persons with income over $60,000, and free file software for
persons with income under $60,000.
Extension of Time To File Your Tax Return (Internal Revenue Service)
http://www.irs.gov/uac/Extension-of-Time-To-File-Your-Tax-Return
Instructions and forms to apply for an extension of time to file. An extension of time to file
does not grant an extension of time to pay the tax liability.
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The Affordable Care Act: What’s Trending (Internal Revenue Service)
http://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/The-Affordable-Care-Act-
Whats-Trending
An excerpt appears below:
When it comes to the health care law—also known as the Affordable Care Act or ACA—
and how it may affect your taxes, there are many questions you might have. This page
offers news on trending topics and answers to questions we are hearing.
Contacts for Tax Filing Assistance
Telephone Assistance (Internal Revenue Service)
http://www.irs.gov/uac/Telephone-Assistance
The Internal Revenue Service (IRS) is implementing many of the ACA’s tax provisions,
including the individual mandate, premium tax credits, and employer shared responsibility
penalties. The Internal Revenue Service (IRS) has a Healthcare Hotline for ACA questions
(800-919-0452) and other telephone hotlines to answer questions from individuals and
employers.
Free Tax Return Preparation for Qualifying Taxpayers (Internal Revenue Service)
http://www.irs.gov/Individuals/Free-Tax-Return-Preparation-for-You-by-Volunteers
An excerpt appears below:
The Volunteer Income Tax Assistance (VITA) program offers free tax help to people
who generally make $53,000 or less, persons with disabilities, the elderly and limited
English speaking taxpayers who need assistance in preparing their own tax returns. IRS-
certified volunteers provide free basic income tax return preparation with electronic filing
to qualified individuals.
Tax Provisions
Affordable Care Act (ACA) Tax Provisions (Internal Revenue Service)
http://www.irs.gov/Affordable-Care-Act
Briefly summarizes the ACA’s tax provisions. Sources are tailored for three categories:
individuals and families, employers, and other organizations. For a more comprehensive list,
click “List of Tax Provisions” in the left navigation bar; for many provisions, there are links
to “Questions and Answers.”
Present Law And Background Relating To The Tax-Related Provisions In The Affordable Care Act
(Joint Committee on Taxation, JCX-6-13, March 4, 2013)
https://www.jct.gov/publications.html?func=startdown&id=4511
Summarizes the ACA’s revenue (tax) provisions.
CRS Report R43342, The Medical Device Excise Tax: Economic Analysis
Since January 1, 2013, manufacturers and importers of medical devices have been subject to
an excise tax equal to 2.3% of the manufacturer’s price. This report gives an overview of the
tax: its legislative origins, its revenue effects, arguments for and against the tax, and its
economic effects.
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CRS Report R44147, Excise Tax on High-Cost Employer-Sponsored Health Coverage: In Brief
The ACA includes a 40% tax on employer-sponsored health coverage that exceeds a specified
dollar limit. Sometimes called the “Cadillac tax,” this tax will be implemented beginning in
2018.
CRS Report R44160, The Excise Tax on High-Cost Employer-Sponsored Health Coverage:
Background and Economic Analysis

An excerpt appears below:
Based on an analysis of employer plans in the 2013 Medical Expenditure Panel Survey
Insurance Component (MEP-IC) dataset, 10.2% of single and 6.0% of non-single
insurance plans have premiums that could exceed the Cadillac tax threshold in 2018
(assuming premiums grow at the same rate as their five-year averages). By 2028, 24.7%
of single and 19.1% of non-single plans have premiums that could exceed the tax
threshold. These estimates do not assume any plan modifications to avoid the tax and do
not include contributions to health-related savings or reimbursement accounts. The share
of plans that could be subject to the tax is sensitive to projections in premium growth
rates.
CRS Report R44159, The Excise Tax on High-Cost Employer-Sponsored Health Insurance:
Estimated Economic and Market Effects

An excerpt appears below:
This report examines several issues. It evaluates the potential of the Cadillac tax to affect
health insurance coverage and the health care market. It also examines the expected
incidence (burden) of the tax—that is, which group’s income will be reduced by the tax.
Finally, the report discusses implications for economic efficiency in the context of tax
administration.
Cost Estimates and Spending
Affordable Care Act (Congressional Budget Office)
http://www.cbo.gov/topics/health-care/affordable-care-act
A collection of Congressional Budget Office (CBO) analyses and cost estimates on the ACA
and proposals to amend or repeal the ACA. Includes analyses of the ACA’s effects on the
federal budget, labor markets, and health insurance coverage.
CRS Report R41390, Discretionary Spending Under the Affordable Care Act (ACA)
According to the report,
The Patient Protection and Affordable Care Act (Affordable Care Act, or ACA)
reauthorized funding for numerous existing discretionary grant programs administered by
the Department of Health and Human Services (HHS). The ACA also created many new
discretionary grant programs and provided for each an authorization of appropriations.
Generally, the law authorized (or reauthorized) appropriations through FY2014 or
FY2015. This report summarizes all the discretionary spending provisions in the ACA.
CRS Report R41301, Appropriations and Fund Transfers in the Affordable Care Act (ACA)
Summarizes the ACA’s mandatory appropriations.
CRS Report R43289, Legislative Actions to Repeal, Defund, or Delay the Affordable Care Act
Includes a section on ACA’s impact on federal spending.
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CRS Report R44100, Use of the Annual Appropriations Process to Block Implementation of the
Affordable Care Act (FY2011-FY2016)

Describes ACA’s impact on federal spending, ACA provisions in enacted appropriations acts,
and ACA provisions in FY2016 appropriations bills.
Tracking Accountability in Government Grants System: Search Affordable Care Act Awards (U.S.
Department of Health and Human Services)
http://taggs.hhs.gov/SearchACA.cfm
Database of selected U.S. Department of Health and Human Services ACA grant awards,
searchable by geographic location, grant program name, grantee name, and keyword. The
database does not include existing programs that received ACA funding in addition to their
regular funding. The database includes grants only, not other types of assistance such as
contracts. Some database dollar amounts are negative; these represent downward adjustments
to previous awards due to cost revisions, corrections, or award cancellations. Some dollar
amounts are zero; these represent grant actions that do not involve the transfer of dollars (for
example, closing out a grant).
CRS Report R43066, Federal Funding for Health Insurance Exchanges
Table 1 details ACA exchange funding to states.
National Health Expenditure Projections 2014-2024 (Centers for Medicare and Medicaid
Services, Office of the Actuary, 2015)
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/
NationalHealthExpendData/Downloads/proj2014.pdf
Projections of national health spending and the ACA’s effects on spending growth.
Statistics on Insurance Coverage
See also “Enrollment Reports.”
Health Insurance Main (U.S. Census Bureau)
http://www.census.gov/hhes/www/hlthins/
National and state health insurance coverage statistics for 2014, and information on how
coverage rates have changed since 2013. From the Highlights: “In 2014, the percentage of
people without health insurance coverage for the entire calendar year was 10.4 percent, or
33.0 million, lower than the rate and number of uninsured in 2013 (13.3 percent or 41.8
million).”
My Congressional District (U.S. Census Bureau)
http://www.census.gov/mycd/
After selecting a congressional district, click “$-Economic” to get 2014 health insurance data
from the American Community Survey.
National Health Interview Survey (Centers for Disease Control and Prevention, National Center
for Health Statistics)
http://www.cdc.gov/nchs/nhis/new_nhis.htm
First-quarter 2015 survey data are available by region; see Health Insurance Coverage: Early
Release of Estimates From the National Health Interview Survey, January-March 2015
(August 2015) http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201508.pdf. Also
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includes 2014 survey data on uninsurance, public health plan coverage, and private health
insurance coverage, by state. See Health Insurance Coverage: Early Release of Estimates
From the National Health Interview Survey, 2014
(June 2015), http://www.cdc.gov/nchs/data/
nhis/earlyrelease/insur201506.pdf; and Health Insurance Annual State Estimate Tables (June
2015), http://www.cdc.gov/nchs/data/nhis/earlyrelease/
State_estimates_insurance_2013_2014.pdf.
The Affordable Care Act Research (U.S. Department of Health and Human Services, Office of the
Assistant Secretary for Planning and Evaluation)
http://aspe.hhs.gov/affordable-care-act-research
Research on ACA’s impacts, including on insurance coverage. See Health Insurance
Coverage and the Affordable Care Act
(September 2015), http://aspe.hhs.gov/health-
insurance-coverage-and-affordable-care-act-aspe-issue-brief-september-2015.
American Factfinder (U.S. Census Bureau)
http://factfinder.census.gov
Contains detailed health insurance coverage data for recent years including 2014. Under
“Advanced Search,” click “Show me all.” Under “Topic or table name,” type Health
Insurance
. Under “state, county or place,” type United States or a state, county, city, or town,
then click “Go.”
Medical Expenditure Panel Survey (Agency for Healthcare Research and Quality)
http://meps.ahrq.gov/
Includes 2014 employer survey data on employer-sponsored insurance; see MEPS Insurance
Component Chartbook 2014
(August 2015) http://meps.ahrq.gov/mepsweb/data_files/
publications/cb19/cb19a.pdf.
Legal Issues
CRS Legal Sidebar: Health and Medicine
http://www.crs.gov/LegalSidebar/Category/52
CRS analysis of health-related legal issues. Includes analysis of ACA-related court cases.
CRS In Focus IF10169, The Affordable Care Act’s Contraceptive Coverage Requirement: History
of Regulations for Religious Objections

The following is an excerpt from the report:
The Affordable Care Act (ACA; P.L. 111-148) requires that group health plans and
health insurance issuers provide coverage for certain preventive health services without
imposing any cost-sharing requirements. 42 U.S.C. §300gg-13(a)(4). The preventive
services covered include Food and Drug Administration (FDA)-approved contraceptive
methods, which generated controversy among employers who oppose the use of
contraception based on their religious beliefs. This requirement has been implemented
through a series of administrative regulations since 2010, when ACA was enacted.
CRS Report R43654, Free Exercise of Religion by Closely Held Corporations: Implications of
Burwell v. Hobby Lobby Stores, Inc.

Discusses the case’s effect on ACA contraceptive coverage requirements. For additional legal
analysis of contraceptive coverage requirements, see CRS Legal Sidebar: Freedom of
Religion, http://www.crs.gov/LegalSidebar/Category/47.
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CRS Report R43474, Implementing the Affordable Care Act: Delays, Extensions, and Other
Actions Taken by the Administration

Summarizes selected administrative actions to address ACA implementation and discusses
the congressional lawsuit U.S. House of Representatives v. Burwell.
Noncitizens
CRS Report R43561, Treatment of Noncitizens Under the Affordable Care Act
Discusses the treatment of noncitizens with respect to the individual mandate, eligibility for
exchange coverage and subsidies, and Medicaid eligibility. Also discusses the verification of
alien status under the ACA.
Health coverage for immigrants (U.S. Department of Health and Human Services,
HealthCare.gov)
https://www.healthcare.gov/immigrants/
Describes the eligibility of immigrants for exchange coverage and subsidies, Medicaid, and
CHIP.
ACA Text
The following resources can help with constituent requests for the text of the ACA.
Compilation of the Patient Protection and Affordable Care Act (U.S. House of Representatives,
Office of the Legislative Counsel)
http://legcounsel.house.gov/HOLC/Resources/comps_alpha.html
The Patient Protection and Affordable Care Act compilation is listed under “P” on this
website. The House Office of the Legislative Counsel compiled the text of the ACA,
consolidated with amendments made by subsequent laws. This compilation is unofficial. It is
updated periodically. As of this writing, the compilation is current through P.L. 114-10,
enacted April 16, 2015.
P.L. 111-148, Patient Protection and Affordable Care Act (Government Publishing Office, March
23, 2010, 124 Stat. 119)
http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf
Unlike the unofficial compilation above, this is the official publication of the ACA as it
passed on March 23, 2010. However, this does not reflect current law, as the ACA has since
been amended by several subsequent laws, including P.L. 111-152, Health Care and
Education Reconciliation Act of 2010, http://www.gpo.gov/fdsys/pkg/PLAW-111publ152/
pdf/PLAW-111publ152.pdf.
Everything You Should Know About The Health Care Law (Government Publishing Office)
http://govbooktalk.gpo.gov/2013/09/24/everything-you-should-know-about-the-health-care-law/
Scroll to “How do I obtain a copy of this Affordable Care Act (ACA)?”

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Author Contact Information

Angela Napili

Information Research Specialist
anapili@crs.loc.gov, 7-0135

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