The Affordable Care Act (ACA) is a major health-care law that was passed in 2010. It has several major goals. One aim is to expand access to health insurance, including by providing financial help to people who buy private coverage in the new marketplaces. Another aim is to encourage preventive health care and improve the quality of care. A third aim is to reduce waste in the health-care system and increase efficiency. And finally, the ACA seeks to promote individual responsibility and accountability for health-care choices.

The ACA includes many other provisions not directly related to health insurance, such as reducing the regulatory burden on small businesses, increasing funding for public health and research, and improving health information technology. However, most of the ACA’s impact is tied to its effect on health insurance.

To expand health-insurance coverage, the ACA created the marketplaces (also called exchanges) where individuals and small businesses could shop for health plans on a level playing field. It also reformed the health insurance industry by prohibiting discrimination against people with preexisting conditions and banning annual and lifetime limits on coverage. The ACA also required all health-insurance plans to include a set of benefits, such as prescription drugs, maternity care, and mental illness treatment. Finally, the ACA eliminated the ability of insurers to charge different premiums based on gender or health status, and limited their ability to vary premiums based on age.

In the individual and small-group markets, the ACA offered tax credits and cost reduction subsidies to make insurance more affordable for low- and middle-income Americans. These new reforms helped to make health insurance available for 19 million more Americans, bringing the nation closer to the goal of near-universal coverage. The ACA also prohibited insurers from denying coverage to children based on a parent’s preexisting condition, and prohibited annual and lifetime limits on coverage for individuals under the age of 19.

To promote healthy behavior, the ACA established the Prevention and Wellness Programs. These programs provide grants to states to implement public health initiatives such as community-based chronic disease management and prevention services for children and adults. They also fund demonstration projects to test innovative ways to better serve populations with special needs, such as the elderly, low-income people, and those with a history of substance abuse or mental illness.