Medicaid expansion

Patient Protection and Affordable Care Act

Long title	The Patient Protection and Affordable Care Act
Acronyms (colloquial)	PPACA, ACA
Nicknames	Affordable Care Act, Health Insurance Reform, Healthcare Reform, Obamacare
Enacted by	the 111th United States Congress
Effective	March 23, 2010; 7 years ago (2010-03-23) Most major provisions phased in by January 2014; remaining provisions phased in by 2020
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 October 8, 2009 (416–0) 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
United States Supreme Court cases
National Federation of Independent Business v. Sebelius Burwell v. Hobby Lobby King v. Burwell

The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) and nicknamed 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. Under the act, hospitals and primary physicians would transform their practices financially, technologically, and clinically to drive better health outcomes, lower costs, and improve their methods of distribution and accessibility.

The Affordable Care Act was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage and reduce the costs of healthcare. It introduced mechanisms including mandates, subsidies, and insurance exchanges. The law requires insurers to accept all applicants, cover a specific list of conditions and charge the same rates regardless of pre-existing conditions or sex.

The ACA has caused a significant reduction in the number of people without health insurance, with estimates ranging from 20–24 million additional people covered during 2016. Increases in overall healthcare spending have slowed since the law was implemented, including premiums for employer-based insurance plans. The Congressional Budget Office reported in several studies that the ACA would reduce the budget deficit, and that repealing it would increase the deficit.

As implementation began, first opponents, then others, and finally the president himself adopted the term "Obamacare" to refer to the ACA.

The law and its implementation faced challenges in Congress and federal courts, and from some state governments, conservative advocacy groups, labor unions, and small business organizations. The United States Supreme Court upheld the constitutionality of the ACA's individual mandate as an exercise of Congress's taxing power, found that states cannot be forced to participate in the ACA's Medicaid expansion, and found that the law's subsidies to help individuals pay for health insurance are available in all states, not just in those that have set up state exchanges.

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Wikipedia