Definition of Obamacare

"Obamacare" is the word used by Republicans to deride President Barack Obama's signal achievement of his first term - reforming the US healthcare system - but it is a word that Democrats are increasingly using in an attempt to destigmatise it.

In 2010, Mr Obama signed "The Patient Protection and Affordable Care Act", as his reforms are officially known, realising a goal that had eluded generations of Democratic leaders, even if the changes did not extend as far as the president initially hoped.

The law banned insurers from refusing coverage to those with pre-existing medical conditions and also allowed dependents to remain on their parents' healthcare plans until the age of 26, two hugely popular provisions.

However, to make the reforms workable, the law introduced the “individual mandate” - a requirement for almost all Americans to buy health insurance by 2014 or pay a penalty.

Lower income people are eligible for financial subsidies to help pay for insurance, while states have to set up "health exchanges" by 2013 to allow individuals and small businesses to band together and get better deals on health insurance, the same way that big companies do already. [1]

Private insurers would have an incentive to participate in the exchange: the prospect of competing for millions of Americans without insurance. [2]

Insurance companies had complained that they would not be able to survive if they had an influx of expensive customers, thanks to the ban on refusing to cover sick people, without the off-setting benefit of having millions of healthy patients on their books.

Republicans had challenged the mandate as unconstitutional, but the Supreme Court ruled that it was not in 2012. However, it did not uphold the law in its entirety, declaring the expansion of the Medicaid health insurance plan -  for low-income and disabled Americans -  to be at odds with the Constitutional because it required states to expand coverage or lose all federal Medicaid funding. [3]


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