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Build a Purpose-Driven Book of Business with ACA
A mere 15 years ago, an unexpected accident or medical diagnosis could send a family spiraling into poverty. Losing a job could mean losing health insurance and access to necessary medical care and life-saving medications. Then, the Affordable Care Act (ACA) changed that story.
Since the ACA was launched in 2010, more than 45 million Americans have gained healthcare coverage. The ACA safety net included protections such as not being denied for pre-existing conditions, covering preventive care, and no gender-based premium differences.
For insurance agents, ACA plans have opened an entirely new market, with more than 24.2 million people enrolled in Plan Year 2025. Agents can offer plans that are meaningful and affordable, while also growing a sustainable and recurring book of business.
Before ACA: Balancing Health Needs Against Financial Ruin
Before ACA, many people were forced into bankruptcy, poverty, and even homelessness because they were trying to pay for a life-saving medication or procedure. Preventive care was an afterthought. It was easy to slip into the ranks of the uninsured.
Even routine wellness exams such as pap smears, prostate exams, mammograms, and colonoscopies were often skipped because they were too expensive. Losing a job wasn’t just a financial setback; it meant losing access to healthcare and, sometimes, financial ruin.
In 1985, the Consolidated Omnibus Budget Reconciliation Act (COBRA) became an option. If you lose your job, whether voluntarily or involuntarily, you may continue your employer’s group health plan under COBRA for up to 18 months.
However, it is seldom a realistic option for those with middle- to low-income levels. What many people didn’t know, and many still do not know, is that COBRA requires individuals to pay the entire cost of the premium, including the portion their former employer used to pay.
With an additional required 2% administrative fee, workers pay 102% of their group plan cost. While COBRA was not the primary reason for the creation of the ACA, it definitely provided a more positive outcome for workers who couldn’t afford it, especially those who had just lost their jobs.
Introducing the Luxuries of Minimum Essential Coverage (MEC)
Fast forward. Oh, how things have changed. In the world of insurance, ACA is well-known. It is a safety net that continues to change and evolve. Millions now have coverage that protects them from the catastrophic costs associated with managing chronic conditions.
The 10 Essential Health Benefits (EHBs) are a set of ten categories of health services that most health insurance plans are required to cover under the ACA. The Minimum Essential Coverage (MEC) is the baseline of health coverage to meet the ACA’s individual mandate requirement, which generally includes plans that cover these 10 EHB categories:
- Outpatient care
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services
- Prescription drugs
- Preventive services (like screenings and vaccinations) and chronic disease management
- Laboratory services
- Rehabilitative and habilitative services and devices
- Pediatric services, including dental and vision for children
Offering these EHB categories as a baseline transformed the healthcare landscape, giving millions of people hope and the expectation of a healthier future. Today, the bare minimum MEC is no longer a luxury but a regulated expectation available to those who have an ACA plan.
There are still many people who fall into pockets of poverty, homelessness, food insecurity, unemployment, and underemployment. Just having ACA coverage may be a luxury for them. Many are often surprised to learn they may also qualify for $0 premiums.
The biggest challenge is finding people who are unaware of the ACA or identifying those who may qualify for $0 or low-cost coverage options. Connecting with people who need ACA but are struggling with chronic conditions and managing their care like it’s pre-ACA. Some still avoid care due to the costs involved.
Before ACA and still today, health insurance is more than just a financial tool of deductibles and copays; it’s a lifeline. Agents have the opportunity and responsibility to meet clients where they are and guide them toward ACA coverage that protects both their health and their finances.
OEP is the Interval Training of the Insurance World
In running, interval training involves alternating bursts of speed with steady recovery periods. Selling ACA coverage is the interval training of the insurance world, with the Open Enrollment Period (OEP) as the high-intensity sprint.
During the short period of OEP, your focus should be speed, accuracy, and responsiveness. Then, after OEP, it is essential to nurture relationships, meet new prospects, and refine your skills in networking, community involvement, and grassroots marketing, all gradually and steadily.
Agents who run fast year-round plateau and burn out. It’s better to space your “sprints” a few times a year, when you can make a significant impact, such as OEP, and for a few select events that ensure your business gains mass exposure to potential clients.
Consider ramping up during high-energy times. Be a part of holiday parades, set up a booth at a fair, sponsor a Little League team, sponsor a golf outing, food truck event, or a fundraiser. What do all of these have in common?
They are highly attended, visual events, where you maximize your exposure to the community. People remember who sponsored their child’s baseball team or who handed out candy at the local parade. Become known and let people know you are invested in the community.
Be genuine and connect with those you want to serve. This grassroots marketing style will help you grow and build a stronger book of business, move more quickly, and become more efficient year after year. This will create the fuel you need to burst through the high-speed sprints.
If you're ready to become the go-to ACA agent in your community, check out Messer's ACA Star Program. Elevate your career with industry-leading support and resources. At Messer, we have your back!
