The United States is described as one of the best healthcare systems in the world. However, healthcare is the industry that impacts the lives of most Americans on a daily basis. As a result, more than 40 million people in the United States do not have health insurance, which is primarily due to issues of access, cost, quality, and coordination of health care across populations (Starfield, 2000). so that everyone has health coverage in the United States. Access, cost, quality and coordination of healthcare have been hot topics for decades now. It was the subject of change, a change that I believe can finally be achieved thanks to the Patient Protection and Affordable Care Act (PPACA). It doesn't matter whether people are rich, poor or sick; everyone will be able to seek healthcare. That said, the law will expand coverage and reduce the number of uninsured and underinsured people by 70% (Schoen, Doty, Robertson & Collins, 2011). The call for Medicaid expansion was the first step in reducing the number of uninsured people and is currently underway. However, the decision to expand Medicaid ultimately rested with each U.S. state. For example, the state of Georgia has not opted to participate in Medicaid expansion, which is causing many people to fall into the “Medicaid Gap,” or those who cannot afford private health insurance and are not eligible for Medicaid. On the other hand, most states have decided to participate in the expansion of Medicaid, Michigan is one of them. Michigan, hit hard by the collapse of the auto industry in the 1970s and 1980s, needed this expansion most. The car accident caused most of the pop... half of the paper... and the 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, H. H., & Sebelius, K. G. (2010). Promote prevention through the Affordable Care Act. NEngl J Med, 363:1296-1299. DOI: 10.1056/NEJMp1008560.Ku, L. (2010). Ready, Prepare, Plan, Implement: Execute Medicaid Expansion. HealthAffairs, 29(6), 1173-1177. DOI: 10.1377/hlthaff.2010.0417.Schoen, C., Doty, M.M., Robertson, R.H., & Collins, S.R. (2011). Reforms to the Affordable Care Act could reduce the number of underinsured U.S. adults by 70%. Sanitary Affairs, 30 (9), 1762-1771. DOI: 10.1377/hlthaff.2011.0335.Starfield, B. (2000). Is American healthcare 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