The Affordable Care Act

Abstract

This article reviews the salient features of the Affordable Care Act, the most important piece of health care reform legislation since the adoption of Medicare and Medicaid in 1965. It pays particular attention to Medicaid expansion, health benefit requirements, employer and individual mandates, the exchanges or marketplaces, subsidies, funding and the so-called Cadillac tax. The ACA had to be superimposed on an elaborate employment-based and government-augmented health benefit system that had grown and evolved since World War II. While far from perfect and in need of repair, the ACA may have been the best that could have been done under the circumstances. The article concludes with a discussion of the politics of amendment or repeal of the ACA.