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Health insurance reform — Texas

In March 2010, President Obama signed into law the Patient Protection and Affordable Care Act (ACA) and the Healthcare and Education Reconciliation Act, which (along with several amendments made by subsequent laws) are often referred to as the “Affordable Care Act” or the “ACA.”

The ACA has caused profound changes in how healthcare coverage is provided in the United States. One stated goal of the ACA is to have virtually all individuals in the United States covered under some sort of arrangement that provides minimum essential coverage for essential health benefits. An individual may obtain this coverage through an individual policy, through an eligible group health plan sponsored by his or her employer or through a government program such as Medicare or Medicaid.

To achieve this goal, the ACA required the creation of state-based insurance marketplaces, referred to as “exchanges,” where individuals can comparison-shop for individual and family coverage. A federally created exchange serves customers in states that declined to create their own exchanges. The exchanges also administer a program for the advance payment of refundable tax credits that can be used to pay a portion of the premium for coverage obtained through the exchange. The ACA also...

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