Nine years after the Affordable Care Act (ACA) became law, millions more people have access to health insurance and insurers are required to cover more services. But a number of factors threaten the law’s long-term stability. The nation’s uninsured population has begun to rise again, and drug prices and other health care costs are increasing. President Trump continues to use his rule-making authority to erode key ACA provisions, and a federal judge recently declared the law unconstitutional in a case expected to reach the Supreme Court. The 2010 law and overall health care policy will be key issues in the 2020 presidential campaign, with some Democratic candidates calling for a Medicare-for-All plan that they say would keep health care cost increases in check. Critics of the proposal call it overly disruptive and expensive.

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