Government-funded health care coverage for the poor (Medicaid, established in 1965) and for those age 65 and older (Medicare, begun in 1966) is available to Americans who meet the programs' income or age qualifications. Nonetheless, the United States remains the only developed nation without a system of universal health care. In 2017, 12.2% of the population did not carry health insurance. The subject of uninsured and underinsured Americans is a major political issue. The Affordable Care Act (ACA), passed in early 2010 and informally known as "ObamaCare", roughly halved the uninsured share of the population. The bill and its ultimate effect are still issues of controversy in the United States. The U.S. health care system far outspends that of any other nation, measured both in per capita spending and as a percentage of GDP. However, the U.S. is a global leader in medical innovation.