Patient Protection and Affordable Care Act of 2010 (PPACA) (also known as the Affordable Care Act (ACA) or “Obamacare”) was a major piece of healthcare legislation that intended to decrease the costs of healthcare and increase access to lower income individuals. Some of the most famous provisions of the ACA included: creating federal and state health insurance exchanges, creating an individual mandate requiring most individuals to have insurance or face fines, subsidizing individual plans for those with incomes below 400% of the federal poverty level, requiring large employers to provide healthcare coverage, and increasing Medicaid coverage to individual with incomes up to 133% of the federal poverty level.
The wide sweeping legislation has been subject to many judicial and legislative challenges since its inception. The most famous challenges came in the Affordable Care Act cases where the Supreme Court found the individual mandate to be appropriate under the taxing power of Congress but limited the ability of the ACA to penalize states that did not expand their Medicaid coverage. Other famous judicial challenges to the ACA include the Halbig v. Burwell case questioning the subsidization of the federal exchanges and other challenges to the individual mandates in California v. Texas and other cases all of which resulted in the ACA being upheld.
The ACA also has faced legislative and executive pushback. After gaining majorities in the House of Representatives, Republicans frequently brought legislation to repeal the ACA. After President Trump gained the Presidency and the Republicans gained both chambers of Congress, different legislative proposals attempted to replace the ACA, but without success in Congress, President Trump signed Executive Order 13813 into law which allowed cheaper health insurance plans while simultaneously reducing the minimum benefit requirements and subsidies of the ACA. President Biden signed Executive Order 14009 soon after entering office which reversed the actions of President Trump’s executive orders and allowed new enrollment in ACA plans.
To access the text of the ACA, click here.
[Last updated in March of 2022 by the Wex Definitions Team]