The Patient Protection and Affordable Care Act (PPACA), sometimes called "Obamacare," was legislation passed by the U.S. Congress and signed into law on March 23, 2010. It has far-reaching effects for health care consumers, providers, and the insurance industry. Legislatively, it is likely the most disruptive innovation that the United States has seen since the advent of Medicare and Medicaid via the Social Security Act of 1965. Not unlike when those programs were introduced, PPACA has met with political pushback, legal challenges, and both proponents and opponents in the public and health care industries. This is not uncommon with such sweeping change. In fact, only 26 states opted to adopt Medicaid in 1966, the year after legislation creating the program passed.
One of the major goals of PPACA was to increase access to affordable insurance coverage. It attempts to do so through two mechanisms: (1) the existing Medicaid program and (2) newly created health insurance marketplaces that will operate in each state. As of September 2013, roughly half of states had opted to expand their Medicaid programs through PPACA after the U.S. Supreme Court ruled in June 2012 in National Federation of Independent Business v. Sebelius that requiring states to expand Medicaid was unconstitutional. Arkansas has taken a unique approach to extending coverage to very low-income populations through the Arkansas Health Care Independence program.
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