DQ 1 Most of the key issues of the law are highlighted; addresses issues of costs, health insurance availability, and quality, "it has attained the main achievement of making insurance universally obtainable (Hall, 2014, 1054), while focusing on the escalating costs of health insurance. The key changes to the implementation of the ACA over the years; assuring health insurance coverage to the growing number of those without insurance, especially those with existing conditions, "barring bias due to preexisting provisions" (McLaughlin C. & McLaughlin, D., 2014, 149). Making all Americans required to purchase health insurance or pay a tax that would defray the costs of their illness, "promoting individual responsibility" (McLaughlin, 151), with some exceptions. The debates concerning the ACA, Medicare and Medicaid are extraordinarily costly entitlement programs, with costs increasing as the baby boomers retire and move into their later years, "rising healthcare costs to the federal health care programs" (Smith, 2014, 26). Unsure if the ACA is moving towards a universal health care programs, but what is sure, is that everyone will need health insurance as everyone needs electricity, "turns health care in the U.S. into a public utility" (Gorin, 2011, 5). With a large federal budget deficit, it is almost certain there will be more changes in federal entitlement programs. What will change depends on the political process. References: Gorin, Stephen H. (2011). Repealing and replacing the Affordable Care Act: prospects and limitations. Health and Social Work, 36 (1), 3-5. Hall, Mark A. (2014). Evaluating the Affordable Care Act: the eye of the beholder. Houston Law Review, 51 (4), 1029-1056. McLaughlin, C.P., & McLaughlin, C.D. (2014). Health Policy Analysis: An interdisciplinary approach (2 0 ed.). Sudbury, MA: Jones and Bartlett