In 2010, the ACA (formally known as the 'Patient Protection and Affordable Care Act' and commonly known as 'Obamacare') became law, enacting major changes in health insurance. At over 27 million, the number of people without health insurance coverage in the United States is one of the primary concerns raised by advocates of healthcare reform. The rate of adults uninsured for healthcare peaked at 18.0% in 2013 prior to the Affordable Care Act (ACA) mandate, fell to 10.9% in the third quarter of 2016, and stood at 13.7% in the fourth quarter of 2018, based on surveys by the Gallup organization beginning in 2008. ranked 29th in healthcare access and quality. healthcare system to be the most expensive and worst-performing in terms of health access, efficiency, and equity. With this setup, A 2017 survey of the healthcare systems of 11 developed countries found the U.S. are non-profit, 21% are government-owned, and 21% are for-profit. Healthcare facilities are largely owned and operated by private-sector businesses. Healthcare is provided by many distinct organizations, made up of insurance companies, healthcare providers, hospital systems, and independent providers. is the only developed nation without a system of universal healthcare, with a significant proportion of its population not carrying health insurance. Despite this, the country has significantly worse healthcare outcomes when compared to peer nations. Healthcare in the United States is subject to far higher levels of spending than any other nation, measured both in per capita spending and as a percentage of GDP.

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