The Affordable Care Act (ACA) was designed to make healthcare more accessible and affordable for all Americans, and it has certainly achieved that goal. 

The ACA has made healthcare more accessible by expanding Medicaid to cover more people and by providing subsidies to help people purchase insurance on the open market. The subsidies help to offset the cost of insurance, making it more affordable for people who otherwise could not afford it.

The ACA has also changed the way healthcare costs are paid for. Before the ACA, many people paid for healthcare out of pocket, which was often very expensive. The ACA has changed this by creating insurance marketplaces and mandating that everyone have health insurance. This helps to spread the cost of care over a larger group of people, making it more affordable.

The ACA has also made it easier for people to compare the cost of different plans and choose the one that best fits their needs. Many plans now include an online calculator to help people estimate their costs and compare different plans. This has made it easier for people to shop around and find a plan that fits their budget.

Finally, the ACA has made it easier for people to get preventive care. Under the ACA, preventive care is now covered for most people at no additional cost. This means people can get the care they need to stay healthy without worrying about the cost.

While the ACA has certainly changed healthcare costs, there is still much work to be done to make healthcare more affordable for everyone. The cost of healthcare is still too high for many people, and the ACA does not provide enough assistance for those who cannot afford insurance. However, the ACA has made strides in making healthcare more accessible and affordable for all Americans, and it will continue to do so in the future.