Every American citizen and most legal residents are expected to have insurance coverage under the PPACA. However, the policies are expensive, have a large deductible, have limited coverage, and it can be difficult to find a doctor who accepts the policies offered because they pay even less than many employer-provided policies pay. The PPACA called for an increase in Medicaid funding from each state in order to help people who are in the income range where they qualify for partial or full assistance in the monthly payment. Unfortunately, many states did not increase their Medicaid budgets because they did not have the funds to do this. "The American Recovery and Reinvestment Act of 2009 allotted $650 million for reducing the risk factors for, and promoting measures to prevent, chronic disease by encouraging higher levels of physical activity, improving nutrition, lowering the prevalence of overweight and obesity, and decreasing tobacco use and exposure to secondhand smoke" (as quoted in Atlas et al, 2014, Section 11.2, para. 8). The American and Reinvestment Act of 2009 focuses on prevention instead of reactive health care. Most of us seek care after we get sick. The PPACA is hoping to shift the health care paradigm. Consider how the health of Americans is changing, for better or worse. Consider also the different professional roles being created - and how those will be paid - to accommodate the increased number of people receiving health care. You will find more information here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116776/