This Health Policy 101 chapter explores the complex landscape of private health insurance regulation in the United States, detailing the interplay between state and federal regulations that shape access, affordability, and the adequacy of private health coverage. It focuses on key laws such as the Affordable Care Act (ACA) and the Employer Retirement Income Security Act (ERISA), and discusses how regulations impact the private insurance market, illustrating the challenges consumers face in navigating this system.