Congress passed comprehensive health care reform in March 2010 after over a year of debate in both the Senate and the House of Representatives. The Patient Protection and Affordable Care Act (ACA) is aimed at reforming the private health insurance market and ensuring greater access to health insurance coverage. It was signed into law by President Barack Obama on March 23, 2010. President Obama also signed the Health Care and Education Reconciliation Act of 2010 the following week, reconciling the House and Senate versions of the reform legislation.

The issue of federal health care reform has been politically charged for years. It was a prominent topic during the 2008 presidential election, and was touted as a major initiative during President Obama’s first year in office. The legislation’s passage was highly controversial, and garnered unanimous opposition from the Republican members of Congress. Following the November 2010 midterm elections, the new Republican majority in the House passed legislation which would have repealed ACA in its entirety. However, the legislation, titled the Repealing the Job-Killing Health Care Law Act, failed to pass the Senate. Disagreement over the projected effects of ACA, and the legality of its provisions, have led to numerous legal challenges in the federal and state arenas, culminating in a pair of Supreme Court rulings in 2012 and 2015 which, respectively, upheld the constitutionality of the individual mandate [https://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf#page=50]] [PDF] and the availability of tax credits [https://www.supremecourt.gov/opinions/14pdf/14-114_qol1.pdf#page=19] [PDF] for individuals purchasing insurance in states with Federally-run exchanges.