How has ACA changed healthcare in the US since implementation?

More people are insured, reducing the public cost of hospitalization for them. People with preexisting conditions can get insurance and there are no more lifetime caps. There is somewhat more bureaucracy, since records must become computerized and additional codes for actions taken by the health providers. One of the most important factors is that there is consumer protection -if you pay for insurance, the providers must meet certain standards of basic care.