This may sound like a small semantic difference, but the distinction is a big one. The ACA has a goal of covering everyone with health insurance. And while it hasn’t achieved that goal, the years since the law passed have coincided with a major drop in the ranks of the uninsured. Under the law, about 20 million people have gained coverage, according to the best estimates, leaving about 9 percent, or 27 million people, still uncovered.
In contrast, many Republicans say they have a goal of “universal access.” That would mean that everyone would be offered a chance to buy some form of insurance, but not necessarily that everyone will get it.