What is Obamacare?

What the law does

HealthCare.gov describes 3 primary goals for the law:

1. Make affordable health insurance available to more people, with premium tax credits for households with income from 100% to 400% of the federal poverty level.
2. Expand Medicaid to cover adults with income below 138% of the federal poverty level. Not every state has expanded Medicaid.
3. Support new ways of delivering care designed to lower health care costs.

Obamacare isn't a government insurance company. Marketplace plans come from private insurers that must follow ACA rules. See how the Marketplace works.

What Obamacare plans cover: the 10 essential health benefits

1. Ambulatory patient services (outpatient care)
2. Emergency services
3. Hospitalization
4. Pregnancy, maternity and newborn care
5. Mental health and substance use disorder services
6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care

Plans must also cover birth control and breastfeeding support. Preventive services are generally covered at no cost from in-network providers, even before the deductible. Adult dental and vision aren't essential health benefits; some plans add them.

Key protections

• Pre-existing conditions: no plan can reject you, charge you more or refuse to pay for essential health benefits because of a condition you had before coverage started, including pregnancy.
• No lifetime or yearly dollar limits on essential health benefits.
• No cancellation just because you get sick.
• Young adults can usually stay on a parent's plan until 26.
• A yearly cap on what you pay: for Marketplace plans, the in-network out-of-pocket maximum is $10,600 for one person in 2026 and $12,000 in 2027.
• The right to appeal a health plan decision. See how to appeal an insurance denial.

Grandfathered plans (individual policies bought on or before March 23, 2010) don't have to cover pre-existing conditions or preventive care. You can switch to a Marketplace plan during Open Enrollment or when your grandfathered plan year ends.

What it costs in 2026

Your price depends on your ZIP code, age, household, income and the plan you choose. The additional savings available because of the COVID pandemic ended on December 31, 2025, so for 2026 coverage the premium tax credit is generally limited to household income from 100% to 400% of the federal poverty level. As of October 12, 2026, 2027 income levels and savings weren't published. HealthCare.gov says they're coming November 1. See premium tax credit.

Extra savings on deductibles and copays (cost-sharing reductions) are available only in Silver plans. Medicaid and CHIP are free or low cost for people who qualify.

How to get Obamacare coverage

1. Pick the window. Open Enrollment for 2027 coverage on HealthCare.gov runs November 1, 2026 to January 15, 2027. Enroll by December 15 for coverage that starts January 1. If your state runs its own Marketplace, check its dates. Outside that window you need a special enrollment period. Medicaid and CHIP accept applications any time.
2. Apply on HealthCare.gov or your state's Marketplace with your household and expected income for the coverage year.
3. Compare plans on network, drug list, deductible and out-of-pocket maximum, then pay the first premium to start coverage.

Gabriel can quote Marketplace plans for your ZIP code and household, show the price after any tax credit, and open your own application with a licensed agent in most states. You choose the plan and finish the application.

Gabriel is not an insurer. Health insurance quotes and enrollment are handled by Gabriel Labs, Gabriel's separately licensed insurance agency. Gabriel membership is not health insurance and is not an ACA plan.