Conclusion

As the ACA is set to unfold continuously over the decade, many of its effects remain to be seen. Many parties, from the federal government to policy advocacy groups, are actively monitoring its implementation and collecting data about the new status of health care access in America. Legislative and regulatory updates combined with legal challenges ensure that the relative roles of insurers, patients, *121 and providers will not be settled for some time to come. The law continues to be contentious: during the September-October 2013 government shutdown, Congressional Republicans demanded, ultimately unsuccessfully, that government funding be made contingent on the delay or defunding of the ACA.  Implementation of the ACA been fraught with difficulties; for example, the Healthcare.gov site, through which people can browse and apply for insurance plans on the marketplaces, has been riddled with technical difficulties and problems.  The ACA is sure to remain a divisive issue, even as implementation goes forward and its full impact is realized.