For decades, U.S. lawmakers struggled with how to ensure all Americans had health insurance. Every other developed country – and many less developed – had some kind of universal or near-universal coverage. On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act – commonly shortened to Affordable Care Act (ACA), or, among opponents, “Obamacare.” Under the law, an estimated 32 million Americans will get coverage by 2019. Yet the complex, multi-part legislation remains highly divisive and misunderstood. Political and policy uncertainties may shadow, or threaten, implementation in the years to come.
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