Health care is a heavily regulated industry that impacts most Americans—whether as patients or providers—and currently accounts for 16 percent of the national GDP.

The Patient Protection and Affordable Care Act (known as ACA) was signed by President Barack Obama on March 23, 2010 and is believed to be the most significant regulatory overhaul of the U.S. healthcare system since the establishment of Medicare and Medicaid in 1965.1 Notably, New York had in place many of the insurance coverage protections and Medicaid program expansion reforms even before ACA was enacted.

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