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The Patient Protection and Affordable Care Act was passed by Congress and signed into law by President Obama on March 23, 2010. Together, the Health Care and Education Reconciliation Act of 2010 and the Affordable Care Act (ACA) transformed the existing healthcare system in the United States by instituting reforms to increase the quality, affordability, and accessibility of insurance coverage and expand Medicaid. [https://www.cbo.gov/topics/health-care/affordable-care-act]