A lot of the ACA's arrangements involve a growth of the private insurance coverage market. It produces incentives for employers to provide medical insurance and initially needed that nearly all people not covered by their company or a government insurance program (for example, Medicare or Medicaid) purchase private medical insurance (specific mandate).The ACA requires creation of health insurance coverage exchanges, which are government-regulated, standardized health insurance that are administered and sold by private insurance coverage companies. how to qualify for home health care. Exchanges might be established within each state, or states might join together to run multistate exchanges. The federal government also may establish exchanges in states that do not do so themselves.