On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (H.R. 3590), which is intended to reform the U.S. health care system, and marks the biggest shift in U.S. domestic policy since the 1960s. After more than a year of negotiations in Congress, the bill was first passed by the Senate in December 2009, and was then passed by the House of Representatives on March 21, 2010, by a vote of 219-212, without a single Republican in favor. That same day, the House also passed by a vote of 220-211 a companion measure known as the Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872), which the Senate later approved and the president then signed into law. This companion measure contains a package of changes to be made to the Patient Protection and Affordable Care Act.
The new law, estimated to cost $940 billion over 10 years, will eventually expand coverage to 32 million people who are currently uninsured. It will offer tax breaks to small businesses to help them offer insurance to employees; grant subsidies to those in certain income brackets to help them buy coverage; prevent insurance companies from dropping the coverage of people when they get sick or for preexisting conditions; and allow young adults to stay on their parents' policy until they are 26. Starting in 2014, most people will be required to have insurance or pay a penalty, and Medicaid will be expanded to include more of those with the lowest incomes. For a full list of the changes set to take place, starting this year until 2019, see this timeline.
"We are still a people capable of doing big things and tackling our biggest challenges," Obama said of the bill's passage. You can watch a video of President Obama signing the bill into law here, and read the transcript of the president's remarks and the vice president's remarks at the signing of the bill.
Still, a NBC News/Wall Street Journal poll taken just ahead of the bill's passage showed that the American public was evenly split on health care reform, with 46 percent saying a reform bill should pass and 45 percent saying it should not. Also, Attorneys general from a dozen states filed suit to stop the overhaul just minutes after the bill signing, claiming that the law is unconstitutional.
On March 26, 2012, the Supreme Court began three days of hearings on challenges to the constitutionality of the law, and released its decision due in June. The Court upheld the health care law in a 5-4 ruling, with Chief Justice John Roberts casting the deciding swing vote.
To learn more about health care reform and how it will impact you, check out the links below.
5 Truths About Health Care in America
Time breaks it down simply with this chart that compares U.S. health spending to that of other nations. 2008 data show that in the top spot, the U.S. spent $7,026 per capita on health care, while Russia came in last at just $369 per person.
American Recovery and Reinvestment Act (pdf)
Signed into law on Feb. 17, 2009, this act protects health coverage for 7 million Americans who lose their jobs through a 65 percent COBRA subsidy to make coverage affordable. It also invests $19 billion in computerized medical records that are intended to help to reduce costs and improve quality while ensuring patients' privacy.