The U.S. has made great progress in getting more people insured since the Affordable Care Act took effect in 2014. The share of uninsured Americans ages 18 to 64 fell from 18% before the ACA^[1] to 9.5% in 2022. And preexisting conditions no longer prevent coverage or lead to an increase in premiums.

Yet even for those with health insurance, coverage does not ensure access to care, much less high-quality and affordable care....