As the Patient Protection and Affordable Care Act celebrates a birthday on March 23, we look back on the law's biggest moments.
Here are five of the law's most important events.
Supreme Court case on the law's constitutionality
March 2012
The PPACA didn't have to wait long for a truly big moment: Just two years after being signed into law, it went to the Supreme Court in a big way.
The court announced it would hear a case about the law's constitutionality after 26 states — led by Florida — sued the government over the law's linchpin, the individual mandate, arguing individuals couldn't be forced to buy insurance. The court heard three days of politically charged arguments March 26–28, 2012 over the constitutionality of PPACA. It was a case that divided the nation.
Ultimately, we know what happened: On June 28, 2012, the court upheld the individual mandate as a tax by a 5-4 vote, though it ultimately left Medicaid expansion up to the states.
Disastrous HealthCare.gov rollout
October 2013
The Oct. 1, 2013, launch of PPACA's federal exchange, Healthcare.gov, was a hugely anticipated moment for PPACA. But it (hugely) failed to meet expectations.
HealthCare.gov was plagued with so many technical problems upon its launch — first and foremost the website's inability to manage a heavy use load — that Congress decided to hold hearings about it later that month. Early enrollment numbers were far fewer than hoped or anticipated, partly because enrollees were unable to stay on the site long enough to sign up.
While in its second enrollment period Healthcare.gov still suffered from a number of glitches, it performed much better than during its first year.
Kathleen Sebelius's resignation
April 2014
The resignation of Health and Human Services Secretary Kathleen Sebelius in April 2014 closed a major chapter in Obamacare. She resigned just as PPACA topped its first-year enrollment goal.
The secretary of five years was one of the major PPACA players from the beginning: She made a career out of praising, touting and defending the Patient Protection and Affordable Care Act. She announced the law's milestones, and her achievements were directly tied to PPACA's: expanded health care coverage, the elimination of pre-existing condition denial by carriers, and expanded Medicaid.
But she also endured backlash over the administration's PPACA delays, answered questions about concerns over the law and even testified about it. And when HealthCare.gov suffered a disastrous rollout, she took the blame.
Sylvia Mathews Burwell, former director of the Office of Management and Budget, took over as HHS secretary in June 2014.