A Health Services Research journal review of the published literature indicates that the Affordable Care Act has made significant progress in accomplishing two of its main goals–decreasing the number of uninsured and improving access to care. The number of uninsured individuals has substantially decreased through the dependent coverage provision, Medicaid expansion, health insurance exchanges, availability of subsidies, and other policy changes. Affordability of health insurance continues to be a concern for many people, however, and disparities persist by geography, race/ethnicity, and income. Early evidence also indicates improvements in access to and affordability of health care.

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