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Health Law

An introduction to legal research in some of the major aspects of Health Law.


The Patient Protection and Affordable Care Act (ACA) (also known as Obamacare) was signed into law in 2010, but most provisions came into force as of 2014. The law expanded Medicaid eligibility and led to changes in individual insurance markets.

The ACA (available here) is primarily administered by the U.S. Department of Health & Human Services (HHS). For more information about HHS and how they are administering the Act, see here.

The Internal Revenue Service (IRS) is responsible for the tax provisions of the Act. For more information on the Affordable Care Act Tax Provisions, see here.

The Center for Consumer Information & Information Oversight (CCIIO) oversees the implementation of the provisions of the ACA related to private health insurance. In particular, CCIIO works with states to establish new Health Insurance Marketplaces.

See here for a detailed summary of the ACA provided by the Democratic Policy and Communications Committee of the Senate.

Part of the Library of Congress, the Congressional Research Service (CRS) researches and prepares reports for Congress on a variety of topics. Typically, these reports are not made widely available to the public, but there are some exceptions. is a bipartisan coalition dedicated to making these reports to everyone online for free.

CRS has prepared multiple reports on the ACA including:


Affordable Care Act Litigation Still on the Docket After California v. Texas  Referred to as “the most challenged statute in American history” by some commentators, the Patient Protection and Affordable Care Act (ACA) has been the subject of numerous lawsuits since its enactment in 2010—more than 2,000 by one estimate. In June 2021, the Supreme Court dismissed the latest challenge that threatened the entire law’s existence iCalifornia v. Texas, leaving the law intact. The dismissal also preserves other suits challenging particular ACA provisions or the Act’s implementation, and these cases may have implications for health insurers, health care providers, employers, patients, and others. This Legal Sidebar provides relevant background on private health insurance requirements in Title I of the ACA, discusses several notable past or pending ACA cases, and concludes with select legal considerations for Congress.

Patient Protection and Affordable Care Act (ACA): Resources for Frequently Asked Questions, which “provides resources to help congressional staff respond to constituents' frequently asked questions (FAQs) about the law” and provides helpful links for more information on the ACA.

The Individual Mandate for Health Insurance Coverage: In Brief “provides a brief overview of the individual mandate, its associated penalty, and the exemptions from the mandate. The report includes some national- and state-level data on the application of the mandate’s penalty in TY2014 and TY2015.”

Free Exercise of Religion by Secular Organizations and Their Owners: Implications for the Affordable Care Act (ACA) “examines the constitutional and statutory protections related to free exercise of religion, including current Supreme Court interpretations, as well as judicial and legislative avoidance of defining the parameters of religious belief. It also discusses significant examples of existing religious exemptions in current law, including employment nondiscrimination, health care, and public accommodations law. Finally, it analyzes recent federal judicial decisions that have considered the religious freedom rights of commercial entities whose owners have religious objections to the contraceptive coverage requirement.”

Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA) “provides background information about the private health insurance market, including market segments and regulation. It then describes each ACA market reform. The reforms are grouped under the following categories: obtaining coverage, keeping coverage, cost of purchasing coverage, covered services, cost-sharing limits, consumer assistance and other health care protections, and plan requirements related to health care providers.”

Overview of Private Health Insurance Provisions in the Patient Protection and Affordable Care Act (ACA) “provides a broad overview of some of the private health insurance provisions in the ACA and directs readers to more in-depth CRS reports.”   

The Patient Protection and Affordable Care Act’s Essential Health Benefits (EHB) “provides an overview of the first component of the EHB package—the essential health benefits. The report examines how the EHB are defined, regulations related to the EHB, state variation in the EHB, applicability of the EHB to health plans, and how the EHB interact with other ACA provisions.”

Legislative Actions in the 112th, 113th, and 114th Congresses to Repeal, Defund, or Delay the Affordable Care Act “summarizes legislative actions taken during the 112th, 113th, and 114th Congresses to repeal, defund, delay, or otherwise amend the ACA.”

Background Legal Information

Legislative History

Introduced in the House as the "Service Members Home Ownership Tax Act of 2009" (H.R. 3590) by Charles Rangel (D–NY) on September 17, 2009

House Committee consideration by Ways and Means

Passed the House on October 8, 2009 (416-0-16)

Passed the Senate as the "Patient Protection and Affordable Care Act" on December 24, 2009 (60-39-1) with an amendment

House agreed to Senate amendment on March 21, 2010 (219-212)

Signed into law by President Barack Obama on March 23, 2010

Became Public Law No. 111-148

Major Amendments
Health Care and Education Reconciliation Act of 2010

Introduced in the House "To provide for reconciliation pursuant to section 202 of the concurrent resolution on the budget for fiscal year 2010" (H.R. 4872); Passed by the Senate on March 25, 2010 and became Public Law No: 111-152 on March 30, 2010.

The Act was split into Title 1: Coverage, Medicare, Medicaid, and Revenues and Title 2: Education and Health, which included a part on Student Loan Reform.

See here for a detailed summary of the Act provided by the Democratic Policy and Communications Committee of the Senate.

Relevant Supreme Court Cases

National Federation of Independent Business v. Sebelius, 567 U.S. 519 (2012).

Available on The Court upheld (by a vote of 5-4) Congress' power to enact most provisions of the PPACA and the Health Care and Education Reconciliation Act, including the individual mandate to buy health insurance under Congress' taxing power. A majority of the Justices also agreed, however, that a significant expansion of Medicaid, was not a valid exercise of Congress's spending power as it would coerce states to either accept the expansion or risk losing existing Medicaid funding.

For an in-depth analysis of the case, and links to related media and opinions, see

Burwell v. Hobby Lobby, 573 U.S. 682 (2014).

Available on The Court struck down the contraceptive mandate adopted by the Department of Health and Human Services (HHS) under the Affordable Care Act requiring employers to cover certain contraceptives for their female employees, by a 5-4 vote, allowing closely held for-profit corporations to be exempt from a regulation its owners religiously object to, if there is a less restrictive means of furthering the law's interest.

For an in-depth analysis of the case, and links to related media and opinions, see

King v. Burwell, 576 U.S. 473 (2015).

Available on The Court's decision upheld the outlay of premium tax credits to qualifying persons in all states, both those with exchanges established directly by a state, and those otherwise established by the Department of Health and Human Services.

For an in-depth analysis of the case, and links to related media and opinions, see

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