The History of the Affordable Care Act

With the future of the Affordable Care Act up in the air, we thought we’d take a minute to look back and see just where this controversial piece of legislature came from.

The Affordable Care Act as we know it was first proposed when former President Obama was still campaigning in 2008, before his first presidential election. While his concept was hardly new – Democratic presidents had unsuccessfully pursued creating a nationwide insurance system for 75 years – it was proposed as “the largest middle-class tax cut for health care in history.”

Because the Affordable Care Act became such a cornerstone for Obama’s campaign, it’s widely known as Obamacare, although its full official title is the Patient Protection and Affordable Care Act.

Much of the political action surrounding the ACA happened in 2009, the first year of Obama’s presidency. It was on July 14 of this year that House Democrats introduced a 1000-page plan for overhauling the current health care system. Many of our readers may remember the debating that raged throughout that summer (and beyond) as a result of this document.

While the Act was meant to extend insurance to more than 30 million uninsured Americans (primarily by expanding Medicaid and providing federal subsidies to help lower- and middle-income Americans buy private coverage), 26 states as well as the National Federation of Independent Business brought suit in federal court to challenge the mandate that individuals carry insurance or pay a penalty as well as the Medicaid expansion provisions.

House leader John Boehner at the time even said, “This so-called public option is going to force millions of Americans out of their private health insurance into a government-run plan.”

Later that September, Obama addressed critics of the Act via a joint Congress session. He even cited a letter from the recently deceased Sen. Ted Kennedy who urged for the passing of the ACA, calling it a “moral issue” above all that addressed the “fundamental principles of social justice.”

Despite the debating, the US House approved its version of the ACA with a 220-215 vote on November 7, 2009. The senate passed its version later on December 24, after a 60-39 vote. The Senate bill was then amended and approved by the House in a 219-212 vote on March 21, 2010. In this vote, all Republican representatives voted against the bill.

But even with their overwhelming opposition, the Act passed and many nationwide concerns were addressed in its newer versions. The Act pointed out that “nothing in this Act or anywhere in the bill forces anyone to change the insurance they have, period.” It also vowed a “new, transparent and competitive insurance marketplace.”

President Obama signed the bill into law in March 2010 with its major provisions to go into effect beginning January 1, 2014. Significant changes did occur between 2010 and 2014 to prepare insurance providers as well as private citizens for the provisions that would take effect in 2014.

At its signing, Obama reiterated that the ACA affirms “the core principle that everybody should have some basic security when it comes to their health care.”

Now that you know the history, stay tuned for our next blog to learn more about the uncertain future of the Affordable Care Act!

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