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In March 2010, the 111th Congress passed health reform legislation, the Patient Protection and Affordable Care Act (ACA). ACA increases access to health insurance coverage, expands federal private health insurance market requirements, and requires the creation of health insurance exchanges to provide individuals and small employers with access to insurance. It also expands Medicaid coverage. The costs to the federal government of expanding health insurance and Medicaid coverage are projected to be offset by increased taxes and revenues and reduced spending on Medicare and other federal health programs. This book provides an overview of major ACA provisions, implementation and oversight activities.