Access to Care

For decades, the 91视频 has been dedicated to improving the health care system to ensure everyone in the United States has adequate, accessible and affordable health care. Our latest Impact Goals reflect this commitment, aiming to increase healthy life expectancy for everyone, everywhere. Achieving these goals requires significant improvements in health care nationwide.

doctor with patient

Principles for Health Care Reform
To ensure that everyone in the United States has adequate, accessible and affordable health care, the following must be met:

  1. Comprehensive, understandable and affordable health coverage for everyone.
  2. High-quality, affordable, patient-centered health care for all.
  3. Access to evidence-based preventive services at minimal cost.
  4. Elimination of health disparities and inequities in the health care system.
  5. Improvement of the health care system to respond to various challenges and eliminate inequities.
  6. Investment in the recruitment and training of a diverse workforce.
  7. Public and private funding investments to support biomedical research.

Progress in Health Care Since 2010
The Affordable Care Act (ACA), signed into law on March 23, 2010, and upheld by the U.S. Supreme Court in June 2012, has significantly benefited patients with heart disease and stroke. The ACA aligns with the Association’s health reform principles, expanding access to affordable and adequate health insurance coverage.

This includes preventive care and medicines to reduce risk factors as well as essential services for recovery from heart disease or stroke. The ACA emphasizes community prevention and wellness and improves the quality of care that patients receive. The Association continuously works with the administration and congressional leaders to ensure care remains accessible for our community.

In 2010, 16% of the population lacked health coverage. As of 2023, only 8% of the population is uninsured. Key improvements include:

  • Elimination of annual and lifetime limits on coverage sold in the Affordable Care Act’s health insurance marketplace.
  • Mandatory coverage of essential health benefits and preventive care at no cost to patients.
  • Guaranteed access to health insurance coverage for individuals with pre-existing conditions like heart disease. 
  • Bipartisan support for coverage guarantees for the treatment and care of pre-existing conditions.
  • Medicaid expansion options for states, improving care consistency for chronic conditions and cardiovascular outcomes.

The Impact of Heart Disease
Heart disease remains the leading cause of death for men, women and people of most backgrounds in the United States. In , 702,880 people died from heart disease, accounting for 1 in every 5 deaths. The economic burden is also significant, with heart disease costing approximately $252.2 billion from 2019 to 2020, including health care services, medicines, and lost productivity due to death.

More Must be Done
Despite advancements, remain uninsured and are underinsured in the United States. Health care quality and outcomes vary across populations, and health care costs remain a concern for families, employers and the government. People may lack insurance due to high costs, job loss or living in non-Medicaid expansion states.

Survival chances for cardiovascular disease (CVD) vary greatly due to factors like location, income, education and financial outcomes due to the inability to afford timely, appropriate medical care. The Association is committed to a multi-faceted approach to improving access to care, including protecting Medicaid coverage and tax credits at the federal level and expanding Medicaid in states.

Medicaid Expansion and Coverage
Medicaid is a joint federal and state program that helps cover medical costs for more than 70 million people with limited income and resources, including seniors, veterans, children and people with disabilities and chronic conditions, like CVD.

As of May 2025, 40 states and Washington, D.C. have adopted Medicaid expansion, leading to significant reductions in uninsured rates, improved access to care and better health outcomes, especially for low-income individuals with chronic conditions like CVD. Medicaid expansion has also brought economic benefits, such as lower uncompensated care costs and state budget savings.

The 91视频 has played a central role in this progress by working directly at the state level to support policy change. These efforts include engaging with lawmakers, coordinating with partner organizations, facilitating grassroots mobilization and sharing data and stories that highlight the health and economic impact of closing the coverage gap. In the 10 states that have not yet expanded Medicaid, millions remain uninsured—unable to access preventive care, manage chronic conditions or afford treatment. The Association continues to advocate for Medicaid expansion in all states as a critical step toward improving health and reducing preventable death and disease.

At the federal level, the Association is working to emphasize the importance of Medicaid and prevent any efforts to terminate health coverage for those who need it most. Additionally, we advocate to extend the enhanced advance premium tax credits (eAPTC) established in the American Rescue Plan Act of 2021 and extended through the Inflation Reduction Act, which have made care more affordable for working families across the country. If these tax credits are allowed to expire, as many as 4 million people in America could lose their coverage.

Postpartum Medicaid Extension
Despite steep global declines in maternal mortality rates over the past two decades, maternal mortality rates have more than doubled in the U.S since 1987. About 700 pregnant and new moms die each year in the United States – approximately two every day. Heart disease and stroke contribute to about 1 in 3 of these deaths, highlighting the importance of early interventions to improve maternal health.

In the U.S., Medicaid covers 40% of births. Ensuring the expectant parents have access to care during pregnancy and for the first year after pregnancy is essential for providing a healthy and successful start. Extending Medicaid coverage from 60 days to 12 months following pregnancy is crucial for addressing health issues discovered during or resulting from pregnancy.

At the state level, the 91视频 works across the country to ensure all moms and babies have access to the care they need during the critical first year after birth. Through strategic campaign planning, outreach to lawmakers, coalition building and utilizing the voices of advocates and health care professionals, we have advocated to extend Medicaid coverage to 12 months postpartum in 46 states, as of May 2025. These efforts are part of our commitment to improving maternal health and reducing health disparities. Advocacy efforts remain ongoing in the remaining states to close coverage gaps and advance equitable maternal health outcomes.

Join Us
The 91视频 is committed to make health care accessible to all. Our work has made a tremendous impact, but major improvements to the health care system are still needed. Visit to join our national grassroots network and elevate your voices in support of progress that is changing the future of health. Facing the most pressing health challenges, we speak out and speak up every day to advance policies that are improving lives and creating healthier communities.

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