The Patient Protection and Affordable Care Act (PPACA), informally referred to as Obamacare, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law (along with the Health Care and Education Reconciliation Act of 2010) is the principal health care reform legislation of the 111th United States Congress.

PPACA requires individuals not covered by employer- or government-sponsored insurance plans to maintain minimal essential health insurance coverage or pay a penalty unless exempted for religious beliefs or financial hardship, a provision commonly referred to as the individual mandate. The Act also affects certain aspects of the private health insurance industry and public health insurance programs, requires insurance coverage of pre-existing conditions, seeks to extend coverage to 30 million uninsured Americans and increases projected national medical spending while reducing the national deficit, slowing health care cost inflation and lowering projected Medicare spending.

PPACA passed the Senate on December 24, 2009, by a vote of 60–39 with all Democrats and two Independents voting for, and all but one Republican voting against. It passed the House of Representatives on March 21, 2010, by a vote of 219–212, with 34 Democrats and all 178 Republicans voting against the bill.

A majority of the states, and numerous organizations and individual persons, filed actions in federal court challenging the constitutionality of some or all of the elements of PPACA.

On June 28, 2012, in the case of National Federation of Independent Business v. Sebelius, the Supreme Court upheld the majority of the law, ruling that the mandate was constitutional under Congress' taxing authority. The court, however, prevented the federal government from withholding all Medicaid funds to states that fail to comply with the expansion of Medicaid, only permitting them to withhold new Medicaid funding from noncompliant states.

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