​Affordable Care Act (ACA)

The Affordable Care Act (ACA) has dramatically changed the health care landscape in Pennsylvania and primarily affected people who do not have health care or who have limited health care coverage. Individuals and families using this page will be directed to the resources they need to get their health insurance questions answered.


Also, organizations that provide health care services have experienced changes due to the ACA. Provider organizations are encouraged to click on the provider button below to get the information they need to implement the changes under the law. 

Who is affected?

It depends. In accordance with the ACA, effective January 1, 2014, Medical Assistance (MA) eligibility for pregnant women, children, and parents/caretakers will be based on a new Modified Adjusted Gross Income, or MAGI, methodology. If you are in a group not affected by MAGI, your eligibility will continue to be determined by the existing MA eligibility criteria. Non-MAGI groups include:

  • Individuals for whom income determinations are not required, such as individuals receiving Supplemental Security Income (SSI), federal and state foster care or adoption assistance recipients and recipients of Breast and Cervical Cancer Prevention and Treatment (BCCPT) services.
  • Individuals who are eligible on the basis of being aged, blind, or disabled.
  • Individuals evaluated for long-term care facility services or home and community-based services (HCBS).
  • Individuals evaluated for Medicare cost-sharing assistance.
  • Individuals evaluated for MA coverage as Medically Needy Only (MNO).
  • Individuals evaluated for MA coverage in General Assistance (GA)-related MA categories.
  • For individuals not currently eligible for Medicaid or are uninsured, health insurance coverage will be available via the federal exchange. More information can be found at www.insurance.pa.gov or www.healthcare.gov.

If you have additional questions beyond what is provided here, please call: 1-866-550-4355.