The Affordable Care Act (ACA) is a landmark U.S. federal statute signed into law by President Barack Obama on March 23, 2010. The individual mandate requires required consumers and their dependents to have health insurance or pay a penalty. The law currently remains in effect.

The ACA is more entrenched than ever, with record enrollment levels and widespread reliance on its benefits. As of 2024, over 40 million Americans have health coverage through ACA programs, a 50% increase since 2017. This growth is largely due to expanded Medicaid programs in both Republican and Democratic states and new subsidies that make coverage more affordable. These expansions have made the law politically challenging to dismantle, even in conservative areas that benefit significantly from the funding and coverage.

Despite some Republican proposals to "reform" the ACA, there is currently no detailed plan to replace it. Past attempts to repeal it have failed, and even states with Republican leadership often push back against efforts to end the program due to its benefits for their residents.