“The Affordable Care Act (ACA) (also known as the Patient Protection and Affordable Care Act or Obamacare) fundamentally changed healthcare coverage, insurance, and regulation in the United States. Due to the strong views in favor of and opposed to the ACA, it was enacted in an unorthodox and controversial process. An important result of the process used to enact the law is that the ACA is not one single health care bill that became law, but is actually composed of two laws: Patient Protection and Affordable Care Act (ACA) (Pub. L. No. 111-148, 124 STAT. 119) and Health Care and Education Reconciliation Act of 2010 (HCERA) (Pub. L. No. 111-152, 124 Stat. 1029).
“The ACA was enacted on March 23, 2010. HCERA was enacted on March 30, 2010, to reconcile major differences between the Senate bill and the House version of the health care legislation. Prior to this law, Congressional Democrats had intended to have a conference committee merge the ACA with the “Affordable Health Care for America Act” (H.R. 3962) that had passed the House of Representatives. Due to the election of Republican Scott Brown in a special election to fill the seat vacated by the death of Sen. Edward Kennedy (D-MA), Republicans had the votes needed to filibuster a conference report on the House and Senate bills. Although HCERA significantly amends the ACA, because it is a budget reconciliation bill it could only be used to make budget amendments. However, it was legislatively expedient; and most importantly, a reconciliation bill can be passed with a simple majority and cannot be filibustered under Senate rules, which became the only way to pass it after Senator Brown’s election.
“The ACA is divided into 10 titles and Title X significantly amends the other titles (requiring consolidation of the other titles with their Title X amendments). Thus, understanding the ACA requires knowledge about the amendments made by Title X of the ACA, the changes made by HCERA, and other subsequently enacted amendments.”
- Patient Protection and Affordable Care Act (ACA) (Pub. L. No. 111-148, 124 STAT. 119)
- Health Care and Education Reconciliation Act of 2010 (HCERA) (Pub. L. No. 111-152, 124 Stat. 1029)
Source: Research Guide: Health Law & Policy. University of Minnesota Law Library. Last updated Aug 15, 2019.
According to the website HealthCare.gov, the Affordable Care Act is:
“The comprehensive health care reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”).
“The law has 3 primary goals:
“• Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level.
“• Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level. (Not all states have expanded their Medicaid programs.)
“• Support innovative medical care delivery methods designed to lower the costs of health care generally.”
Source: HealthCare.gov Glossary: Affordable Care Act. Last accessed August 15, 2019.
Resources for More Information on the ACA and ACA Innovations
US Dept of Health and Human Services, Agency for Healthcare Research and Quality, AHRQ Healthcare Innovations Exchange
Patient-Centered Outcomes Research Institute (independent foundation established by the Affordable Care Act)
PCORI’s collection of research publications, articles, papers, commentaries, etc.
National Conference of State Legislatures: State Health Systems Innovations
The Commonwealth Fund: The ACA’s Innovation Waiver Program: A State-by-State Look
Hester, R.D. The successful innovations of the affordable care act of 2010. J Innov Entrep 6, 18 (2017) doi:10.1186/s13731-017-0076-x
Health Affairs Journal Blog: Following the ACA
Kaiser Family Foundation, ““What is CMMI?” and 11 other FAQs about the CMS Innovation Center”
You can also find the full text of the Affordable Care Act through Healthcare.gov.
Health System Overview
Health System Rankings
Health System Outcomes
Health System Financing
Coverage and Access
Costs for Consumers
Health System Resources and Utilization
Healthcare Workforce Education
Long-Term Services & Supports
Health Information and Communications Technologies
People With Disabilities
Social Determinants & Health Equity
World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.
Page last updated July 17, 2023 by Doug McVay, Editor.