The Affordable Care Act, also known as Obamacare, is a landmark piece of healthcare legislation passed in 2010. With the passage of the ACA, many Americans received health insurance for the first time. It forbade insurers from denying applicants due to “pre-existing conditions,” expanded Medicaid eligibility, and offered premium subsidies, among other things. However, the ACA falls short in significantly regulating the market and preventing issues such as price gouging. It has been a deep source of contention for politicians of both sides of the aisle. Republican politicians tend to see it as an example of government industry into the private sector, and some Democrats wish to see it expanded further.

The allowance is the amount an insurer has agreed to pay for a particular treatment or medication. This number is determined after negotiations with a hospital or drug manufacturer. A lack of transparency around negotiation processes contributes to the high costs that patients are expected to shoulder.

An ancillary service is any additional treatment a patient receives after receiving bare bones care. This definition has grown over the years, and now includes tests, physical therapy, imaging, and ambulances. Since the classification for an ancillary service has grown significantly, it is easy for doctors and insurers to exploit.