On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act, commonly known as “Obamacare.” The legislation levied billions in new taxes, primarily on the rich; it increased the salaries of primary care physicians; and it forced fast food restaurants to provide calorie counts for menu options. However, the law did nothing to streamline the US health care system and it doesn’t offer universal coverage. Instead, it has expanded coverage through Medicaid and private insurance offered through “exchanges” that provide options based on what people can afford. One of the most important provisions is that insurance companies can no longer refuse coverage to those with preexisting conditions. Additionally, the law offers subsidies to “seniors who can’t afford to pay for their prescriptions under Medicare” (250). The act has also set up a new federal agency, The Independent Payment Advisory Board, to make recommendations regarding how much Medicare should pay doctors and hospitals for treatments.

The most controversial part of the legislation is the individual mandate—that is, that everyone is required to sign up for health insurance to create a large enough pool of healthy consumers to fund those who are sick or injured. Conservatives argued that this was unconstitutional on the basis that no government should dictate what a citizen buys.