Patient Protection and Affordable Care Act (ACA)

Patient Protection and Affordable Care Act (ACA) (2010)

1) Link to the Text of the Act
Read the statute (42 U.S.C. § 18001 et seq.)

2) Why It Was Done
The ACA was enacted to expand access to affordable health insurance, improve quality of care, and reduce healthcare costs. It created health insurance marketplaces, expanded Medicaid, and prohibited insurers from denying coverage for preexisting conditions.

3) Pre-existing Law or Constitutional Rights
Built upon the Social Security Act (Medicare and Medicaid provisions) and existing insurance regulations, but established the first nationwide mandate for health coverage and sweeping insurance reforms.

4) Overreach or Proper Role?
Supporters view it as landmark healthcare reform and an essential expansion of coverage. Critics argue it imposed federal overreach, especially with the individual mandate (later reduced to zero penalty in 2017) and Medicaid expansion requirements (partially struck down by the Supreme Court).

5) Who or What It Controls

Individuals (mandated to obtain insurance until 2017 tax penalty repeal)
Insurers (required to cover preexisting conditions, essential benefits, no lifetime caps)
Employers (large employer mandate to provide insurance)
States (Medicaid expansion, health exchanges)
Healthcare providers (quality and reporting standards)

6) Key Sections / Citations

42 U.S.C. § 18001 et seq. (core ACA provisions)
26 U.S.C. § 5000A (individual mandate, now zeroed penalty)
42 U.S.C. § 1396a (Medicaid expansion requirements)

7) Recent Changes or Live Controversies

2012 Supreme Court ruling (NFIB v. Sebelius): upheld most of the ACA but made Medicaid expansion optional for states
2017 Tax Cuts and Jobs Act: reduced individual mandate penalty to $0
Ongoing litigation challenges (e.g., over contraception mandates, subsidies, and preventive services)
Political debates over whether to expand, repeal, or reform ACA provisions

8) Official Sources