Finally, the ACA mandated that people with preexisting conditions could no longer be denied health insurance. The

U.S. Department of Health and Human Services estimates that the those without insurance in the US has fallen from

20.3% in 2012 to 11.5% in 2016. Accordingly, 20 million Americans gained coverage under the ACA. According to

the Census, as of 2020, the share of the population without health insurance had fallen to 8.6%. So the ACA has
402 16 • Information, Risk, and Insurance

resulted in a decline in the percentage of Americans without health insurance by almost 60%.

What was the cost of this increased coverage and how was it paid? An insurance policy works by insuring against the

possibility of needing healthcare. If there are high risk individuals in the insurance pool, the pool must be expanded

to include enough low risk individuals to keep average premiums affordable. To that end, the ACA imposed the
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