Ten Years After: The ACA’s Success in Five Charts

President Obama signing the Affordable Care Act in front of a crowd of legislators and citizens.
At a historic signing ceremony in the East Room of the White House on March 23, 2010, President Barack Obama approves the Affordable Care Act surrounded by congressional and administration officials, advocates, and Vice President Joe Biden. Photo: J. Scott Applewhite / Associated Press 

President Barack Obama made history on March 23, 2010, when he signed into law the landmark Affordable Care Act (ACA), transforming the health care landscape in California. Here are a few examples of the health care law’s impact:

  • The number of uninsured Californians dropped by 3.7 million — the biggest decline of any state.
  • As the uninsured rate fell across all groups, racial disparities in coverage declined. In California, there is no longer a statistically significant difference in the uninsured rate among whites, Blacks, and Asians. That is a major shift from before the ACA was fully implemented. Among Latinos, however, the uninsured rate remains higher compared to other groups.
  • Because the ACA bars insurers from denying coverage, 16.8 million Californians who have preexisting conditions are protected from ever being rejected by a health insurer.
  • At California hospitals between 2013 and 2017, uncompensated care costs plummeted by $1.7 billion.
  • Research estimates that the ACA’s Medicaid expansion saved 19,200 lives nationwide. Research also shows how the expansion improved mortality rates for infants, new mothers, and people with cardiovascular diseases and reduced consumers’ medical debt.

From the beginning, California embraced the ACA, taking full advantage of the opportunities and tools the law provided to expand coverage. In the last few years, California has built on the ACA’s solid foundation, expanding the state Medicaid program, Medi-Cal, to all children and young adults with low incomes regardless of immigration status, and providing additional subsidies to help people afford coverage on the state’s ACA health insurance exchange, Covered California.

Lots More to Do

There’s more to be done, of course. About three million Californians still remain uninsured, and health care costs are still too high and rising too fast.

COVID-19 is a stark reminder that when it comes to health, we are all in this together. In this moment, it’s clear how all Californians benefit when more Californians have the coverage and access to care they need. As the ACA turns 10, CHCF celebrates the significant progress it has made for California, and continues, with our partners, the unfinished work of achieving universal coverage.

Download and share these cards documenting the ACA’s success in California on social media using the hashtag #ACA10, and don’t forget to share your own ACA story too.

Learn more about the ACA’s impact from Health Affairs.