The United States is touted as having one of the best healthcare systems in the world. However, healthcare is the industry that affects the lives of most Americans on a daily basis. As a result, more than 40 million people lack health insurance in the United States, primarily due to issues with access, cost, quality, and coordination of health care across different populations. (Starfield, 2000). Essentially, the dream is for everyone to have health coverage in the United States. Access, cost, quality, and coordination of health care have been hot topics for decades. This has been the subject of change, a change that can finally come about through the Patient Protection and Affordable Care Act (PPACA), in my opinion. It doesn't matter whether people are rich, poor or sick; everyone will be able to benefit from health care. That being said, the law will expand coverage and reduce the number of uninsured and underinsured people by 70 percent (Schoen, Doty, Robertson & Collins, 2011). The request for Medicaid expansion was the first step toward reducing the number of uninsured people and is now in action. However, the decision to expand Medicaid was ultimately up to each state in the United States. For example, the state of Georgia has not decided to participate in Medicaid expansion, leaving many people in the “Medicaid Gap” or those who cannot afford private health insurance. and are not eligible for Medicaid. States have decided to participate in Medicaid expansion, Michigan being one of them. Michigan, desperately hurt by the collapse of the auto industry in the 1970s and 1980s, was most in need of this expansion. The car accident caused most of the pop...... middle of paper ...... and Affordable Care Act: Promise and peril for primary care. Ann Intern Med, 152 (11), 742-744. DOI: 10.7326/0003-4819-152-11-201006010-00249. Koh, HH and Sebelius, KG (2010). Promoting prevention through the Affordable Care Act. NEngl J Med, 363: 1296-1299. DOI: 10.1056/NEJMp1008560. Ku, L. (2010). Ready, Defined, Planned, Done: Executing Medicaid Expansion. Health Affairs, 29(6), 1173-1177. DOI: 10.1377/hlthaff.2010.0417. Schoen, C., Doty, MM, Robertson, RH and Collins, SR (2011). Reforms to the Affordable Care Act could reduce the number of underinsured American adults by 70 percent. Health Affairs, 30 (9), 1762-1771. DOI: 10.1377/hlthaff.2011.0335. Starfield, B. (2000). Is American health really the best in the world? JAMA, 284 (4), 483-485. Retrieved from http://extension.oregonstate.edu/coos/sites/default/files/FFE/documents/us_health_care.pdfV