The Patient Protection and Affordable Care Act (commonly known as the ACA, Affordable Care Act, or Obamacare) is major health care legislation passed in 2010 by the 111^th Congress and signed by President Barack Obama.

Over 900 pages long, the ACA includes a bundle of statues and regulations intended to overhaul the public and private health care markets in the United States to increase health care. The ACA expanded Medicaid eligibility, established state-based insurance exchanges for individual buyers, forced all citizens to buy health insurance through an “individual mandate,” required mid-sized and large companies to provide health insurance to full-time employees, and prohibited companies from denying health insurance to employees due to pre-existing conditions^{3 17} In 2012, the Supreme Court ruled that the individual mandate was a constitutional use of the federal government’s power to tax in a 5-to-4 ruling. ³

While the ACA has likely benefited low-income Americans, it has done so at the expense of middle-class Americans by shifting the costs and benefits in the insurance system. For instance, prior to the passage of Obamacare, tax credit subsidies for individual insurance purchasers declined with income and ended at $98,400. Medicaid drove most efforts to support healthcare access. Meanwhile, due to numerous regulations and subsidies, health insurance providers had little incentive to offer affordable middle-class insurance plans. For instance, in Virginia in 2017, the cheapest available plan for a standard middle-class family of four cost $30,000 per year. ²⁷

Additionally, many of the cost cuts on low-tier insurance plans were financed by direct subsidies from the federal government to insurance companies. In 2017, insurance companies asked for $8 billion in subsidies. ³

Proponents also point to the removal of time and monetary limits on health insurance as a major benefit of the ACA. Individuals with long-term or expensive healthcare issues are protected by federal regulations which require indefinite healthcare provisions. ³

Criticisms

The individual mandate has been one of the most controversial aspects of the ACA. Despite the 2012 Supreme Court ruling holding the mandate a tax, many right-leaning critics believe the individual mandate violates the U.S. Constitution by forcing individuals to purchase a service. ³ In 2017, the Tax Cuts and Jobs Act lowered the mandate tax penalty to zero, functionally eliminating the individual mandate. ²⁹

The ACA has also been criticized for raising $500 billion in new taxes, including on medical devices and other goods which would improve the quality of healthcare in the long run. 0){ let parent=divs[divs.length-1].parentNode; let footer=divs[divs.length-1]; delete divs[divs.length-1]; for (let i=2; i