Healthcare Reform

This issue brief shows coverage gains among young adults under the Affordable Care Act, the American Rescue Plan, and the Inflation Reduction Act. The uninsured rate among this group declined by more than half, from 31.5 percent in 2009 to 13.1 percent in 2023, as employer-sponsored dependent coverage increased by over 20 percent.

This Issue Brief examines the impact of Medicaid throughout its six decades and highlights the importance of Medicaid coverage for low-income children and adults. The brief reviews studies showing that access to Medicaid coverage is associated with a significant improvement in health and mortality.

The Inflation Reduction Act (IRA) makes improvements to Medicare to increase accessibility and affordability of prescription drugs for Medicare enrollees, reduce the rate of growth in Medicare drug spending, and improve the financial sustainability of the Medicare program.

Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) experienced larger relative gains in health insurance coverage than any other racial or ethnic group in the United States since the Affordable Care Act was enacted in 2010.

The uninsured rate for nonelderly Latinos decreased from 32.7 percent to 18.0 percent, from 2010 to 2022, however, Latinos are more than twice as likely to be uninsured as non-Latino Whites.

Recent legislative and administrative policy initiatives have built on the Affordable Care Act’s (ACA) expansion of health insurance coverage and improvements in access to and utilization of health care services.

Since the implementation of the Affordable Care Act’s coverage provisions, the uninsured rate among nonelderly Black Americans decreased by 10 percentage points, from 20.9 percent in 2010 to 10.8 percent in 2022.

Effective January 1, 2023, the Inflation Reduction Act (IRA) eliminated cost sharing and deductibles for adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) covered under Medicare Part D. In 2023, 10.3 million Medicare Part D enrollees received a recommended vaccine free of charge, which saved enrollees more than $400 million in out-of-pocket costs.

This issue brief presents Marketplace enrollment and plan selections by race and ethnicity among 2015-2023 Open Enrollment Period enrollees in HealthCare.gov states using combined self-reported race and ethnicity information with imputed data for missing values.

The Affordable Care Act substantially transformed the market for non-group private health insurance, introducing new consumer protections and coverage standards and establishing Health Insurance Marketplaces.