A number of the ACA's provisions involve an expansion of the private insurance market. It produces rewards for companies to supply medical insurance and originally needed that almost all individuals not covered by their employer or a federal government insurance coverage program (for example, Medicare or Medicaid) purchase personal medical insurance (private mandate).The ACA needs creation of medical insurance exchanges, which are government-regulated, standardized health strategies that are administered and sold by personal insurance provider. what is the affordable health care act. Exchanges might be developed within each state, or states may collaborate to run multistate exchanges. The federal government also might establish exchanges in states that do not do so themselves.