Percentage of clients receiving services at health clinics funded by Title X by insurance coverage status, Family Planning Annual Reports, 2005–2015. The dashed vertical line in the middle of the chart indicates 2010, when the ACA legislation was signed (March 23, 2010) and some provisions took effect, including the measure allowing children to stay on parent’s insurance plans until age 26. The dashed line on the right indicates January 1, 2014, when ACA-enabled Medicaid when expansions first took effect in 24 states and Washington, D.C. Private insurance plans purchased between October 1, 2013, and December 15, 2013, through the state or federal Marketplaces also began to take effect on January 1, 2014. ACA, Patient Protection and Affordable Care Act.