Numerous of the ACA's provisions include a growth of the private insurance market. It creates rewards for employers to supply health insurance and initially needed that almost all people not covered by their company or a federal government insurance program (for example, Medicare or Medicaid) purchase personal medical insurance (private required).The ACA needs creation of health insurance coverage exchanges, which are government-regulated, standardized health insurance that are administered and sold by personal insurance provider. how many jobs are available in health care. Exchanges may be established within each state, or states may sign up with together to run multistate exchanges. The federal government also might develop exchanges in states that do refrain from doing so themselves.