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FACT SHEET: The Affordable Care Act: Secure Health Coverage for the Middle ClassThe Supreme Court's decision to uphold the Affordable Care Act ensures hard-working, middle class families will get the security they deserve and protects every American from the worst insurance company abuses. This law was also specifically designed to give States the resources and flexibility they need to tailor their approach to their unique needs. With the uncertainty about the Court’s decision behind us, it’s now time to focus on implementing this law in a smart and non-bureaucratic way that works for the middle class.Benefits and Protections for the Middle Class: The Affordable Care Act includes numerous provisions to keep health care costs low, promote prevention, and hold insurance companies accountable. If you’re one of the 250 million Americans who already have health care – whether through private insurance, Medicare, or Medicaid – the Affordable Care Act is already making your coverage more secure.· Insurance companies no longer have unchecked power to cancel your policy, deny your child coverage due to a pre-existing condition, or charge women more than men.· Over 86 million Americans have gained from coverage of preventive care free of charge, like mammograms for women and wellness visits for seniors.· Nearly 13 million Americans will receive a rebate this summer because their insurance company spent too much of their premium dollars on administrative costs or CEO bonuses.· The law has already helped 5.3 million seniors and people with disabilities save an average of over $600 on prescription drugs in the “donut hole” in Medicare coverage.· The law’s provisions to strengthen and protect Medicare by fighting fraud will continue.· The law has helped 6.6 million young adults who have been able to stay on their parents’ plans until the age of 26, including 3.1 million young people who are newly insured.If you are one of the 30 million Americans who don’t yet have health insurance, starting in 2014 this law will offer you an array of quality, affordable, private health insurance plans to choose from. If you need care, you will finally have the same opportunity to get quality, affordable coverage as everyone else.Coverage for Americans with Pre-Existing Conditions: A major impact of the Court's decision is that 129 million people with pre-existing conditions will have the security of affordable health coverage. Starting in 2014, insurance companies can no longer charge you more, carve out benefits, or deny you coverage altogether because you have cancer or diabetes or simply because you are a woman. To make these protections affordable, people with and without pre-existing conditions should be insured, since everyone at some time needs health care.Tax Credits for Middle Class Families and Small Businesses: Millions of Americans will soon be eligible for tax credits to ensure that their health insurance is affordable. Under today’s ruling, having health insurance is and will continue to be a choice. If you can’t afford insurance or you’re a small business that wants to provide affordable insurance to your employees, you’ll get tax credits that make coverage affordable. But starting in 2014, if you can afford insurance and you choose not to purchase it, the taxpayers will no longer subsidize your care for free. The Court’s ruling today allows Congress to hold the projected 1% of Americans who will be able to afford health insurance but will choose not to buy it responsible for that choice. Many small businesses are already receiving tax credits so they can afford to offer quality health care to their employees. To date, 360,000 businesses that employ 2 million workers have already benefitted from the small business tax cuts in the law. And once the Affordable Care Act takes full effect, about 18 million individuals and families will get tax credits for health insurance coverage averaging about $4,000 apiece.Support for State Implementation of Affordable Insurance Exchanges: With the uncertainty of the Court decision behind us, we will step up our work with States to implement Affordable Insurance Exchanges. Exchanges are new marketplaces, starting in 2014, that will allow individuals and small businesses to compare and choose private health plans. Each State will take the lead in designing its own menu of options. Already, 34 States including the District of Columbia have received 100 percent Federally funded grants to build Exchanges. The use of Exchange grants includes support for activities related to running Exchanges in their start-up year.States can also implement their own brand of reform through Innovation Waivers starting in 2017. If States can come up with even better ways of covering people at the same quality and low cost, this law allows them to do so. The Administration supports bipartisan legislation to allow States to start such Waivers in 2014.Moving Forward, Not Back: No political party has a monopoly on good ideas, and the President will work with anyone to provide basic security for middle class families and end the worst insurance company abuses. But rather than refight old partisan battles by starting over on health care and repealing basic protections that provide security for the middle class, Congress needs to work together to focus on the economy and creating jobs. Right now, Congress should act on the President’s concrete plans to create an economy built to last by reducing the deficit in a balanced way and investing in education, clean energy, infrastructure, and innovation.