Health Care Reform in the United States: The Affordable Care Act

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On 23 March 2010, President Barack Obama signed the Patient Protection and Affordable Care Act into law. The result of months of political conflict and compromise, this law entails a comprehensive reform of the U.S. health care system meant to expand coverage for those with and without insurance and curb the rapid growth of health care spending as a proportion of GDP. The law also includes a timeline for phasing in new regulations.

Expanding Coverage and Improving Performance

The Affordable Care Act aims to make health insurance more accessible to the uninsured and increase coverage for the under-insured. In order to do so, the law:

  • Creates an individual mandate, which requires all individuals who can afford it to purchase health insurance or pay a fine. This provision is meant to cover the costs created by other provisions of the law for insurance providers.
  • Establishes “Affordable Insurance Exchanges,” which simplify consumers’ search for health insurance and should instigate more competition, and therefore lower prices, between insurance providers.
  • Implements a number of requirements on insurance providers which make it more difficult to deny coverage to those seeking to purchase health insurance.
  • Provides tax benefits and additional incentives to small businesses that purchase insurance on behalf of their employees.
  • Expands Medicaid and Medicare programs.
  • Eliminates lifetime caps on insurance spending.

Cutting Costs

Furthermore, the Affordable Care Act is meant to reduce the amount spent on health care. In order to do so, the law:

  • Incentivizes better care coordination for health care providers, meant to decrease redundancies in health care provision.
  • Implements a number of requirements and rules meant to make Medicare and Medicaid more efficient.
  • Requires private insurers to cover preventive care. The law also expands Medicare and Medicaid benefits for preventive care.
  •  Establishes a number of organizations and funds that seek solutions in bringing down the cost of health care.


The Patient Protection and Affordable Care Act has garnered significant criticism, mostly targeted at the individual mandate, which critics say is unconstitutional, as it requires individuals to purchase a service. As a result, the reform has become a major issue in the upcoming presidential election and has faced several legal challenges. The law is currently under review by the Supreme Court, which will ultimately judge its constitutionality.

For more detailed information on the Patient Protection and Affordable Care Act, see: