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[COLOR=rgb(32, 33, 34)][FONT=-apple-system][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/FONT]
[COLOR=rgb(32, 33, 34)][FONT=-apple-system][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/FONT]

[COLOR=rgb(32, 33, 34)][FONT=-apple-system][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/FONT]
[COLOR=rgb(32, 33, 34)][FONT=-apple-system][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/FONT]

[COLOR=rgb(32, 33, 34)][FONT=-apple-system][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/FONT]
[COLOR=rgb(32, 33, 34)][FONT=-apple-system][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT]
[SIZE=16px][FONT=inherit][SIZE=6][FONT=Linux Libertine]Affordable Care Act[/FONT][/SIZE][/FONT]
[FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Language[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Download PDF[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Watch[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Edit[/FONT][/FONT][/li][/ul][/FONT][/SIZE]
[SIZE=16px][FONT=inherit][FONT=inherit][COLOR=rgb(84, 89, 93)][FONT=inherit]“Obamacare” redirects here. For the Quelle Chris song, see [COLOR=rgb(51, 102, 204)][FONT=inherit]Guns (Quelle Chris album)[/FONT].[/FONT]
[FONT=inherit]The [FONT=inherit]Affordable Care Act[/FONT] ([FONT=inherit]ACA[/FONT]), formally known as the [FONT=inherit]Patient Protection and Affordable Care Act[/FONT], and colloquially known as [FONT=inherit]Obamacare[/FONT], is a United States [COLOR=rgb(107, 75, 161)][FONT=inherit]federal statute[/FONT] enacted by the [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT] and signed into law by [COLOR=rgb(107, 75, 161)][FONT=inherit]President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] on March 23, 2010. Together with the [COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT] amendment, it represents the [COLOR=rgb(107, 75, 161)][FONT=inherit]U.S. healthcare system[/FONT]'s most significant regulatory overhaul and expansion of coverage since the enactment of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT] and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] in 1965.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][2][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][3][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][4][/FONT][/FONT][/FONT]
Affordable Care Act
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit][FONT=inherit]https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Great_Seal_of_the_United_States_%28obverse%29.svg/140px-Great_Seal_of_the_United_States_%28obverse%29.svg.png[/FONT][/FONT][/CENTER]
Long titleThe Patient Protection and Affordable Care Act
[COLOR=rgb(107, 75, 161)][FONT=inherit]Acronyms[/FONT] FONT=inherit[/FONT]ACA, PPACA
NicknamesObamacare, Affordable Care Act, Health Insurance Reform, Healthcare Reform
Enacted bythe [COLOR=rgb(107, 75, 161)][FONT=inherit]111th United States Congress[/FONT]
EffectiveMarch 23, 2010[FONT=inherit]; 11 years ago[/FONT]
Most major provisions phased in by January 2014; remaining provisions phased in by 2020; penalty enforcing individual mandate eliminated starting 2019
[CENTER]Citations[/CENTER]
Public law[COLOR=rgb(107, 75, 161)][FONT=inherit]111–148[/FONT]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Statutes at Large[/FONT]124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]119[/FONT] [FONT=inherit]through[/FONT] 124 [COLOR=rgb(107, 75, 161)][FONT=inherit]Stat.[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]1025[/FONT] (906 pages)
[CENTER][FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Legislative history[/FONT][/FONT][/CENTER]
[FONT=inherit][FONT=inherit][ul]
[li][FONT=inherit][FONT=inherit]Introduced in the House[/FONT] [FONT=inherit]as[/FONT] [FONT=inherit]the[/FONT] “Service Members Home Ownership Tax Act of 2009” ([COLOR=rgb(107, 75, 161)][FONT=inherit]H.R. 3590[/FONT]) [FONT=inherit]by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Charles Rangel[/FONT] ([COLOR=rgb(107, 75, 161)][FONT=inherit]D[/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit]NY[/FONT]) [FONT=inherit]on[/FONT] September 17, 2009[/FONT][/li][li][FONT=inherit][FONT=inherit]Committee consideration by[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Ways and Means[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the House on[/FONT] November 7, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]220–215[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Passed the Senate as the [/FONT]“Patient Protection and Affordable Care Act”[FONT=inherit] on[/FONT] December 24, 2009 ([COLOR=rgb(107, 75, 161)][FONT=inherit]60–39[/FONT]) [FONT=inherit]with amendment[/FONT][/FONT][/li][li][FONT=inherit][FONT=inherit]House agreed to Senate amendment on[/FONT] March 21, 2010 ([COLOR=rgb(107, 75, 161)][FONT=inherit]219–212[/FONT])[/FONT][/li][li][FONT=inherit][FONT=inherit]Signed into law by President[/FONT] [COLOR=rgb(107, 75, 161)][FONT=inherit]Barack Obama[/FONT] [FONT=inherit]on[/FONT] March 23, 2010[/FONT][/li][/ul][/FONT][/FONT]
[CENTER]Major amendments[/CENTER]
[COLOR=rgb(107, 75, 161)][FONT=inherit]Health Care and Education Reconciliation Act of 2010[/FONT]
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
Public Law 115-97 proposed as the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT]
[CENTER][COLOR=rgb(107, 75, 161)][FONT=inherit]United States Supreme Court[/FONT] cases[/CENTER]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]Burwell v. Hobby Lobby[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]King v. Burwell[/FONT][/FONT]
[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]California v. Texas[/FONT][/FONT]
[FONT=inherit]The ACA’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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][5][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][6][/FONT][/FONT] The law also enacted a host of [COLOR=rgb(107, 75, 161)][FONT=inherit]delivery system[/FONT] reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][7][/FONT][/FONT]
The increased coverage was due, roughly equally, to an [COLOR=rgb(107, 75, 161)][FONT=inherit]expansion of Medicaid eligibility[/FONT] and to changes to [COLOR=rgb(107, 75, 161)][FONT=inherit]individual insurance[/FONT] markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare Advantage[/FONT]. Several [COLOR=rgb(107, 75, 161)][FONT=inherit]Congressional Budget Office[/FONT] reports said that overall these provisions reduced the [COLOR=rgb(107, 75, 161)][FONT=inherit]budget deficit[/FONT], that repealing ACA would increase the deficit,[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][8][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][9][/FONT][/FONT] 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.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][10][/FONT][/FONT]
The act largely retained the existing structure of [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicare[/FONT], [COLOR=rgb(107, 75, 161)][FONT=inherit]Medicaid[/FONT] and the [COLOR=rgb(107, 75, 161)][FONT=inherit]employer market[/FONT], but individual markets were radically overhauled.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][1][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][11][/FONT][/FONT] Insurers were made to [COLOR=rgb(107, 75, 161)][FONT=inherit]accept all applicants[/FONT] without charging based on [COLOR=rgb(107, 75, 161)][FONT=inherit]preexisting conditions[/FONT] or demographic status (except age). To combat the resultant [COLOR=rgb(107, 75, 161)][FONT=inherit]adverse selection[/FONT], the act [COLOR=rgb(107, 75, 161)][FONT=inherit]mandated[/FONT] that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of “[COLOR=rgb(107, 75, 161)][FONT=inherit]essential health benefits[/FONT]”.
Before and after enactment the ACA faced strong political opposition, calls for repeal and [COLOR=rgb(107, 75, 161)][FONT=inherit]legal challenges[/FONT]. In [FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit]National Federation of Independent Business v. Sebelius[/FONT][/FONT], the [COLOR=rgb(107, 75, 161)][FONT=inherit]Supreme Court[/FONT] ruled that states could choose not to participate in the law’s Medicaid expansion, but upheld the law as a whole.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][12][/FONT][/FONT] The federal health insurance exchange, [COLOR=rgb(107, 75, 161)][FONT=inherit]HealthCare.gov[/FONT], faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a [COLOR=rgb(107, 75, 161)][FONT=inherit]plurality[/FONT] of Americans opposed the act, although its individual provisions were generally more popular.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][13][/FONT][/FONT] By 2017, the law had majority support.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][14][/FONT][/FONT] President [COLOR=rgb(107, 75, 161)][FONT=inherit]Donald Trump[/FONT] rescinded the federal tax penalty for violating the [COLOR=rgb(107, 75, 161)][FONT=inherit]individual mandate[/FONT] through the [COLOR=rgb(107, 75, 161)][FONT=inherit]Tax Cuts and Jobs Act of 2017[/FONT], starting in 2019.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][15][/FONT][/FONT] This raised questions about whether the ACA was still constitutional.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][16][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][17][/FONT][COLOR=rgb(107, 75, 161)][FONT=inherit][18][/FONT][/FONT] The Supreme Court upheld the ACA a third time in a June 2021 decision.[FONT=inherit][COLOR=rgb(107, 75, 161)][FONT=inherit][19][/FONT][/FONT][/FONT][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/SIZE][/FONT][/FONT][/FONT]