Changes

Individuals and families who earned enough money to not qualify for Medicaid, and were not covered by employer-provided insurance, were then required to purchase insurance through health care exchanges in order to receive federal subsidies of insurance premiums and deductibles.  However, there were massive problems with the online health care exchanges operated by the federal government for states that did not set up their own exchanges.  This was true at the start of the open season in October 2013 as well as toward the end of the open season in March 2014.  Despite these problems, 7.1 million people signed up for insurance on the exchanges.<ref>{{cite news|url=http://www.whitehouse.gov/blog/2014/04/01/more-7-million-americans-have-enrolled-private-health-coverage-under-affordable-care|title=7.1 Million Americans Have Enrolled in Private Health Coverage Under the Affordable Care Act|work=whitehouse.gov|date=April 1, 2014}}</ref>  This number does not indicate a growth in the number of people covered by private health insurance.  First, the 7.1 million includes people who became covered by Medicaid expansion.  Second, some of the people were already covered by a grandfathered health plan, but were forced to purchase on the exchange so as to receive premium and deductible subsidies.  Third, some states, like California, required insurance companies to cancel their existing insurance plans as a precondition of offering plans on the health care exchanges.

Individuals and families who earned enough money to not qualify for Medicaid, and were not covered by employer-provided insurance, were then required to purchase insurance through health care exchanges in order to receive federal subsidies of insurance premiums and deductibles.  However, there were massive problems with the online health care exchanges operated by the federal government for states that did not set up their own exchanges.  This was true at the start of the open season in October 2013 as well as toward the end of the open season in March 2014.  Despite these problems, 7.1 million people signed up for insurance on the exchanges.<ref>{{cite news|url=http://www.whitehouse.gov/blog/2014/04/01/more-7-million-americans-have-enrolled-private-health-coverage-under-affordable-care|title=7.1 Million Americans Have Enrolled in Private Health Coverage Under the Affordable Care Act|work=whitehouse.gov|date=April 1, 2014}}</ref>  This number does not indicate a growth in the number of people covered by private health insurance.  First, the 7.1 million includes people who became covered by Medicaid expansion.  Second, some of the people were already covered by a grandfathered health plan, but were forced to purchase on the exchange so as to receive premium and deductible subsidies.  Third, some states, like California, required insurance companies to cancel their existing insurance plans as a precondition of offering plans on the health care exchanges.

Some people thought that they had purchased insurance through the exchange, but because of malfunctions in the back office of the exchange, the insurance providers did not receive any record of the insurance purchase.  The Obama Administration  launched a crash program to fix the federal exchange software and eventually replaced the contractor responsible for building and operating the healthcare.gov website.

Some people thought that they had purchased insurance through the exchange, but because of malfunctions in the back office of the exchange, the insurance providers did not receive any record of the insurance purchase.  The Obama Administration  launched a crash program to fix the federal exchange software and in January 2014 replaced the contractor responsible for building and operating the healthcare.gov website.<ref>{{cite news|url=http://www.washingtonpost.com/blogs/post-politics/wp/2014/01/10/obama-administration-to-replace-top-healthcare-gov-contractor/|title=Obama administration to replace top HealthCare.gov contractor|date=January 10, 2014|accessdate=April 3, 2014|work=Washington Post|author= Juliet Eilperin and Amy Goldstein}}</ref>

Although a number of Americans gave up their grandfathered health care plans for new policies.  If the number of people purchasing policies under the ACA is not sufficient, insurance companies will raise their rates in future years, perhaps trapping these Americans who gave up their rights to switch back to the grandfathered plans.

Although a number of Americans gave up their grandfathered health care plans for new policies.  If the number of people purchasing policies under the ACA is not sufficient, insurance companies will raise their rates in future years, perhaps trapping these Americans who gave up their rights to switch back to the grandfathered plans.