In Mar. 2010, the US Congress passed HR 3590, the Patient Protection and Affordable Care Act (PPACA), and HR 4872, the Health Care and Education Reconciliation Act of 2010. President Barack Obama signed both into law in late Mar. 2010. The PPACA included an individual mandate that imposed tax penalties on people who chose not to buy health insurance. On June 28, 2012, the US Supreme Court upheld the constitutionality of the PPACA in a 5-4 ruling.
Proponents of the health care legislation, frequently referred to as Obamacare, have called it a historic political achievement and landmark legislation that reformed the US health care system by lowering health care costs, making health care more affordable, and protecting consumers. They cited the Congressional Budget Office estimates that it would reduce the nation’s deficit by about $210 billion.
Opponents have called it a socialist and unconstitutional government takeover of the health care system that would increase the cost of health care, decrease the quality, and entrench a new entitlement. They said the law will increase the nation’s deficit $340-$700 billion over the next decade. In 2011 and 2012 the House of Representatives voted 36 different times to repeal or replace Obamacare.
President Trump made a campaign promise to repeal and replace Obamacare, and has repeated that intention since taking office. The Tax Cuts and Jobs Act, signed by Trump in 2017, eliminated the Obamacare individual mandate penalty starting in 2019. This led to a Dec. 2018 federal district court ruling that struck down the entire Affordable Care Act based on the premise that the individual mandate had become an order rather than a tax. On Dec. 18, 2019, a federal appeals court agreed that the mandate was unconstitutional without the tax penalty but allowed other parts of the law to stand, sending the case back to lower courts. Defenders of the mandate indicated their intention to take the case to the Supreme Court.