I have two questions regarding the Affordable Care Act. They are in bold and und

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I have two questions regarding the Affordable Care Act. They are in bold and und

I have two questions regarding the Affordable Care Act. They are in bold and underlined.
How does
ACA help low-income individuals purchase health insurance?
The ACA
created health insurance with federal financial assistance that will reduce the
premiums and deductibles and allows states to expand Medicaid to adults with
133% poverty. ACA helps provide insurance for people who are self-employed,
work in industries that do not have insurance, part-time workers, people who
are low income, and people who retire before they are 65 (Sullivan, n.d.).
My
question is: What else does the ACA do to help low-income individuals purchase
health insurance?
Reference
Sullivan, J.
(n.d.). Entering their second decade, Affordable Care Act coverage
expansions have helped millions, provide the basis for further progress.
Center on Budget and Policy Priorities. https://www.cbpp.org/research/health/entering-their-second-decade-affordable-care-act-coverage-expansions-have-helped#:~:text=The%20Affordable%20Care%20Act%20(ACA,to%20138%20percent%20of%20the


Identify at least two key changes to the ACA since its enactment in 2010. (b) Describe those changes and the impact that each change had in the marketplace.
Since its enactment in 2010, the Affordable Care Act (ACA) has undergone several significant changes that have reshaped its structure and impact on the marketplace. One key change occurred with the Tax Cuts and Jobs Act of 2017, which effectively repealed the individual mandate penalty. Originally, the ACA included a mandate that required most Americans to have health insurance or pay a penalty, which was designed to ensure a balanced risk pool by encouraging healthy individuals to purchase insurance. The repeal of this penalty in 2019 led to concerns about the potential destabilization of the insurance markets, as fewer healthy individuals might enroll, thereby increasing the risk pool’s overall cost and potentially leading to higher premiums for those who remain insured. However, the impact has been mixed. At the same time, some insurers reported premium increases, but the market did not experience the catastrophic destabilization some had predicted, possibly due to other stabilizing mechanisms within the ACA and state-level interventions.
Another significant change brought by the ACA was the expansion of Medicaid. The original intention of the ACA was to expand Medicaid coverage by increasing the income eligibility threshold, allowing more low-income individuals to qualify. However, a 2012 Supreme Court ruling made this expansion optional for states. Despite some states opting out, Medicaid enrollment grew substantially, increasing from 58.9 million in 2012 to 73.5 million by 2017 (Feldstein, 2019, p. 129). As a result, a patchwork implementation emerged, with some states embracing the expansion while others did not. States that chose to expand Medicaid experienced significant reductions in uninsured rates and improved access to care for low-income populations. This expansion has profoundly impacted the marketplace by providing a safety net for millions who would otherwise be uninsured, thus reducing the financial burden on emergency healthcare services and enhancing overall public health outcomes. In contrast, states that did not expand Medicaid continue to grapple with higher uninsured rates, adverse health outcomes, and financial strain on both individuals and healthcare providers.
These changes highlight the dynamic nature of the ACA and its ongoing evolution in response to legislative, judicial, and administrative actions. The repeal of the individual mandate penalty and the optional Medicaid expansion are just two examples of how policy shifts can significantly influence the healthcare landscape, affecting insurance markets, coverage rates, and the accessibility of care for millions of Americans.
My question is: Besides the Tax Cuts and Jobs Act of 2017 and the expansion of Medicaid, can you give me two additional key changes with a small description and impact?
References
Michael A. Morrisey. (2020). Health Insurance, Third Edition: Vol. Third edition. AUPHA/HAP Book.
Paul Feldstein. (2019). Health Policy Issues: An Economic Perspective, Seventh Edition: Vol. Seventh edition. AUPHA/HAP Book.
Kaiser Family Foundation. (2018, December 17). Summary of the Affordable Care Act. KFF. https://www.kff.org/affordable-care-act/fact-sheet/summary-of-the-affordable-care-act/
Forum on Medical and Public Health Preparedness for Catastrophic Events; Board on Health Sciences Policy; Board on Health Care Services; Institute of Medicine. The Impacts of the Affordable Care Act on Preparedness Resources and Programs: Workshop Summary. Washington (DC): National Academies Press (US); 2014 Aug 27. F, Key Features of the Affordable Care Act by Year. Available from: https://www.ncbi.nlm.nih.gov/books/NBK241401/

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