This chapter briefly discusses the history of the Affordable Care Act (ACA) and community and presents specific components of the ACA in relationship to community prevention. The chapter deals with specific aspects of the legislation that impact older adults and people with disabilities. It presents a short review of the ten titles: Title one: quality, affordable health care for all Americans; Title two: role of public program; Title three: improving the quality and efficiency of health care; Title four: prevention of chronic disease and improving public health; Title five: health care workforce; Title six: transparency and program integrity; Title seven: improving access to innovative medical therapies; Title eight: Class Act; Title nine: revenue provision; Title ten: strengthening quality, affordable health care for all Americans. The chapter explains some of the legislative highlights, policies, and programs that have been articulated within each of the specific titles of the ACA.

This chapter discusses the history of the Medicare in the United States; specific components of Medicare Parts A, B, C, and D; and how Medicare provides healthcare resources to older adults and people with disabilities. Medicare, a healthcare program perceived to be a universal program rather than one based upon a needs test, currently provides healthcare to people who reach the age of 64. Comprised of four parts, it can provide hospital care, general healthcare, hospice care, home healthcare, and prescription drug coverage. The chapter provides an overview of the Medicare program, its various components, and aspects of healthcare that are covered through its component parts. Although there are currently no needs tests or limitations as to who qualifies for services, the chapter concludes with some dilemmas for the future of healthcare coverage, including “an empty pot at the end of the rainbow” and rationing of healthcare services and procedures.