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[Series] The Affordable Care Act: implications for health-care equity

Inequalities in medical care are endemic in the USA. The Affordable Care Act (ACA), passed in 2010 and fully implemented in 2014, was intended to expand coverage and bring about a new era of health-care access. In this review, we evaluate the legislation’s impact on health-care equity. We consider the law’s coverage expansion, insurance market reforms, cost and affordability provisions, and delivery-system reforms. Although the ACA improved coverage and access—particularly for poorer Americans, women, and minorities—its overall impact was modest in comparison with the gaps present before the law’s implementation.