Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 220.127.116.11. If your access is via an institutional subscription, please contact your librarian to request reinstatement. If you are using a personal subscription, please contact the Duke University Press using the Contact Us form.
The Patient Protection and Affordable Care Act (ACA) of 2010 clearly builds on the existing health care system in the United States. By creating health insurance exchanges, the ACA attempts to extend the use of private insurance companies to expand coverage. It also attempts to improve existing public programs, namely, Medicaid and Medicare. Frank J. Thompson's essay on Medicaid and Daniel P. Gitterman and John C. Scott's on Medicare both analyze how the programs will change under the ACA and consider the political aspects of reform.