Health Reform

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ACA Basics

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The Affordable Care Act is the nation’s health reform law enacted in March 2010. The law aims to reform both our private and public health insurance systems, in order to expand coverage to 24 million Americans by 2023. Among the law's many goals: increase benefits and lower costs for consumers, provide new funding for public health and prevention, bolster our health care and public health workforce and infrastructure, foster innovation and quality in our system, and more.

There are many reasons health reform is critically needed in the U.S., including:

  • High uninsured rate: In April 2014, the CBO estimated (PDF) that 42 million Americans under the age of 65 are currently uninsured; representing about 1 out of 6 Americans in that age group. Without the ACA, the uninsured rate would continue to rise. 

  • Unsustainable spending: Health care spending represented 17.2 percent of our gross domestic product in 2011.

  • Lack of emphasis on prevention: Today, seven in 10 deaths in the U.S. are related to chronic diseases such as obesity, diabetes, high blood pressure, heart disease, and cancer, which are largely preventable. Additionally, 75 percent of our health care dollars are spent treating such diseases. However, only three cents of each health care dollar spent in the U.S. (PDF) go toward prevention.

  • Poor health outcomes: The U.S. spends far more on medical care than any other industrialized nation, but ranks 26th (PDF) among 36 OECD countries in terms of life expectancy.

  • Health disparities: While inequities related to income and access to coverage exist across demographic lines, population-based disparities are impossible to deny.

The ACA won’t solve all of these problems overnight, but it’s an important step forward. By making health coverage more affordable and accessible and thus increasing the number of Americans with coverage, by funding community-based public health and prevention programs, and by supporting research and tracking on key health measures, the ACA can help begin to reduce disparities, improve access to preventive care, improve health outcomes and reduce the nation’s health spending.

Key Resources

Presentation slides: The Impact of the Affordable Care Act on State and Local Public Health Systems (April 2013): PowerPoint slides on "ACA 101" and questions for public health to consider as health reform is implemented

APHA fact sheet: Affordable Care Act Overview: Selected Provisions (PDF): a clear, concise chart summarizing and explaining the structure and major provisions of the health reform law

APHA fact sheet: Why Do We Need the Affordable Care Act? (PDF): a one-page graphic summarizing the critical U.S. health system problems the ACA is intended to address

APHA fact sheet: The Prevention and Public Health Fund (PDF)

APHA Chart: Agenda for Health Reform and Relevant Provisions in PPACA (PDF): Summary of ACA prevention provisions

APHA Chart: Major ACA Delivery and Payment Reforms: (PDF) a table that summarizes the health care payment and delivery reforms of the ACA

APHA Issue Brief: The Prevention and Public Health Fund: (PDF) an issue brief that describes the need for dedicated public health funding and the Prevention and Public Health Fund's goals 

APHA Issue Brief: Prevention Provisions in the Affordable Care Act: (PDF) an issue brief that provides details on the ACA's major prevention initiatives

APHA Issue Brief: The Affordable Care Act's Public Health Workforce Provisions: (PDF) this issue brief describes the current challenges facing the public health work force and how the ACA addresses them.

Text of the law: Summaries of the ten sections of PPACA

Kaiser Family Foundation: Summary of the New Health Reform Law (PDF, updated April 2013), The Uninsured: A Primer (updated October 2013) and The Uninsured and the Difference Health Insurance Makes (September 2012)

Commonwealth Fund: 'Find Health Reform Provisions' tool (interactive)

Health Reform GPS: Reform Overview (one Web page), Implementation Briefs (a set of pages on various topics) or glossary

National Conference of State Legislatures: Affordable Care Act and Minority Health (webinar, July 2013)

Urban Institute: FAQ How does the health care law affect me? 

Department of Health and Human Services: The ACA's impact on different populations (fact sheets, updated September 2013) and Health Care Infographics

Families USA: Health Equity (quick facts, toolkit, and more)

For more information, visit our Useful Links page.