Patient Protection and Affordable Care Act From Wikipedia, the free encyclopedia Jump to navigationJump to search This article has multiple issues. Please help improve it or discuss these issues on the talk page. (Learn how and when to remove these template messages) This article possibly contains original research. (August 2019) Some of this article's listed sources may not be reliable. (August 2019) The neutrality of this article is disputed. (August 2019) Patient Protection and Affordable Care Act Great Seal of the United States Long title The Patient Protection and Affordable Care Act Acronyms (colloquial) PPACA, ACA Nicknames Obamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform Enacted by the 111th United States Congress Effective March 23, 2010; 10 years ago Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019 Citations Public law 111–148 Statutes at Large 124 Stat. 119 through 124 Stat. 1025 (906 pages) Legislative history Introduced in the House as the "Service Members Home Ownership Tax Act of 2009" (H.R. 3590) by Charles Rangel (D–NY) on September 17, 2009 Committee consideration by Ways and Means Passed the House on November 7, 2009 (220–215) Passed the Senate as the "Patient Protection and Affordable Care Act" on December 24, 2009 (60–39) with amendment House agreed to Senate amendment on March 21, 2010 (219–212) Signed into law by President Barack Obama on March 23, 2010 Major amendments Health Care and Education Reconciliation Act of 2010 Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011 Public Law 115-97 proposed as the Tax Cuts and Jobs Act of 2017 United States Supreme Court cases National Federation of Independent Business v. Sebelius Burwell v. Hobby Lobby King v. Burwell President Barack Obama, 2012 portrait crop.jpg This article is part of a series about Barack Obama Political positionsElectoral history Early life and careerFamilyPublic image Pre-presidency Illinois State Senator2004 DNC keynote addressU.S. Senator from Illinois President of the United States Presidency Timeline Policies EconomyEnergyForeign policy Obama DoctrineForeign tripsPardonsSocialSpace Appointments CabinetJudges First term Campaign for the Presidency 2008 general electionPrimaries Transition1st inauguration First 100 daysAffordable Care ActIraq WithdrawalDeath of Osama bin LadenBenghazi attack Timeline '09'10'11'12 Second term Reelection campaign 2012 general electionReactions 2nd inaugurationImmigration executive actionIran dealCuban thaw Timeline '13'14'15'16'17 Post-presidency Planned LibraryObama FoundationOne America Appeal Dreams from My FatherThe Audacity of HopeNobel Peace Prize Barack Obama's signature vte The Patient Protection and Affordable Care Act, also the Affordable Care Act (ACA) or colloquially known as ObamaCare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965. PPACA's major provisions came into force in 2014. By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20 to 24 million additional people covered. The law also enacted a host of delivery system reforms intended to constrain healthcare costs and improve quality. After the law went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans. The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and to changes to individual insurance markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office reports said that overall these provisions reduced the budget deficit, that repealing PPACA would increase the deficit, and that the law reduced income inequality by taxing primarily the top 1% to fund roughly $600 in benefits on average to families in the bottom 40% of the income distribution. The act largely retained the existing structure of Medicare, Medicaid and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of "essential health benefits". Before and after enactment PPACA faced strong political opposition, calls for repeal and legal challenges. In National Federation of Independent Business v. Sebelius, the Supreme Court ruled that states could choose not to participate in PPACA's Medicaid expansion, although it upheld the law as a whole. The federal health exchange, HealthCare.gov, faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a plurality of Americans opposed the act, although its individual provisions were generally more popular and the law gained majority support by 2017.