Barack Obama

====Health care reform====
{{Main|Healthcare reform in the United States}}

Obama called for [[United States Congress|Congress]] to pass legislation reforming [[health care in the United States]], a key campaign promise and a top legislative goal.<ref name="health reform" /> He proposed an expansion of health insurance coverage to cover the uninsured, cap premium increases, and allow people to retain their coverage when they leave or change jobs. His proposal was to spend $900{{spaces}}billion over ten years and include a government insurance plan, also known as the [[public health insurance option|public option]], to compete with the corporate insurance sector as a main component to lowering costs and improving quality of health care. It would also make it illegal for insurers to drop sick people or deny them coverage for [[pre-existing condition]]s, and require every American to carry health coverage. The plan also includes medical spending cuts and taxes on insurance companies that offer expensive plans.<ref>{{cite news |url=https://www.nytimes.com/2009/09/10/us/politics/10obama.html |archive-url=https://web.archive.org/web/20090912093912/http://www.nytimes.com/2009/09/10/us/politics/10obama.html |archive-date=September 12, 2009 |url-access=limited |url-status=live |title = Obama, Armed With Details, Says Health Plan Is Necessary |last1 = Stolberg |first1 = Sheryl Gay |last2 = Zeleny |first2 = Jeff |date = September 9, 2009 |newspaper = The New York Times |access-date = July 5, 2015 }}</ref><ref>{{cite news |first = Mike |last = Allen |url = http://www.politico.com/news/stories/0909/26907.html |title = Barack Obama will hedge on public option |work = [[Politico]] |access-date = July 5, 2015 |date = September 9, 2009 |archive-date = July 26, 2013 |archive-url = https://web.archive.org/web/20130726215752/http://www.politico.com/news/stories/0909/26907.html |url-status = live }}</ref>

[[File:PPACA Premium Chart.jpg|thumb|upright=1.35|left|Maximum Out-of-Pocket Premium as Percentage of Family Income and [[federal poverty level]], under [[Patient Protection and Affordable Care Act]], starting in 2014 (Source: [[Congressional Research Service|CRS]])<ref>{{cite web |url=https://www.fas.org/sgp/crs/misc/R41137.pdf |title = Health Insurance Premium Credits in the PPACA |publisher = Congressional Research Service |access-date = May 17, 2015 |archive-url = https://web.archive.org/web/20121014002318/https://www.fas.org/sgp/crs/misc/R41137.pdf |archive-date = October 14, 2012 |url-status = live }}</ref>|alt=Graph of maximum out-of-pocket premiums by poverty level, showing single-digit premiums for everyone under 400% of the federal poverty level.]]

On July 14, 2009, House Democratic leaders introduced a 1,017-page plan for overhauling the U.S. health care system, which Obama wanted Congress to approve by the end of 2009.<ref name="health reform">{{cite news|url=http://blogs.suntimes.com/sweet/2009/07/obama_july_22_2009_press_confe.html |title=Obama July 22, 2009 press conference. Transcript |work=[[Chicago Sun-Times]] |date=July 22, 2009 |access-date=July 5, 2015 |first=Lynn |last=Sweet |url-status=dead |archive-url=https://web.archive.org/web/20150416063154/http://blogs.suntimes.com/sweet/2009/07/obama_july_22_2009_press_confe.html |archive-date=April 16, 2015 }}</ref> After public debate during the Congressional summer recess of 2009, Obama delivered [[Barack Obama speech to joint session of Congress, September 2009|a speech to a joint session of Congress]] on September 9 where he addressed concerns over the proposals.<ref>{{cite news |url=http://www.cnn.com/2009/POLITICS/09/09/obama.speech/index.html |title = Obama calls for Congress to face health care challenge |date = September 9, 2009 |access-date = September 9, 2009 |publisher = CNN |archive-url=https://web.archive.org/web/20090910083332/http://www.cnn.com/2009/POLITICS/09/09/obama.speech/index.html |archive-date = September 10, 2009 |url-status=live }}</ref> In March 2009, Obama lifted a ban on using federal funds for stem cell research.<ref>{{Cite news |url = https://www.theguardian.com/world/2009/mar/10/obama-stem-cell-research |title = Stem cell |first = Daniel |last = Nasaw |newspaper = The Guardian |access-date = September 13, 2014 |date = March 10, 2009 |archive-date = July 26, 2013 |archive-url = https://web.archive.org/web/20130726203242/http://www.guardian.co.uk/world/2009/mar/10/obama-stem-cell-research |url-status = live }}</ref>

On November 7, 2009, a health care bill featuring the public option was passed in the House.<ref name="nyt1">{{cite news |url=https://www.nytimes.com/2009/11/08/health/policy/08health.html |title = Sweeping Health Care Plan Passes House |last1 = Hulse |first1 = Carl |first2 = Robert |last2 = Pear |date = November 7, 2009 |work = The New York Times |access-date = November 8, 2009 |archive-url=https://web.archive.org/web/20110331033230/http://www.nytimes.com/2009/11/08/health/policy/08health.html|archive-date=March 31, 2011 |url-status=live }}</ref><ref name="nyt">{{cite news |url=https://www.nytimes.com/2009/11/08/health/policy/08scene.html |title = Abortion Was at Heart of Wrangling |last1 = Herszenhorn |first1 = David M. |first2 = Jackie |last2 = Calmes |date = December 7, 2009 |work = The New York Times |access-date = December 6, 2009 |archive-url=https://web.archive.org/web/20110331073732/http://www.nytimes.com/2009/11/08/health/policy/08scene.html|archive-date=March 31, 2011 |url-status=live }}</ref> On December 24, 2009, the Senate passed its own bill—without a public option—on a party-line vote of 60–39.<ref>{{cite news |url=https://www.npr.org/templates/story/story.php?storyId=121854289 |title = Senate Says Yes To Landmark Health Bill |author = Hensley, Scott |date = December 24, 2009 |access-date = December 24, 2009 |publisher = [[NPR]] |archive-url=https://web.archive.org/web/20100121191700/http://www.npr.org/templates/story/story.php?storyId=121854289 |archive-date = January 21, 2010 |url-status=live }}</ref> On March 21, 2010, the [[Patient Protection and Affordable Care Act]] (ACA, colloquially "Obamacare") passed by the Senate in December was passed in the House by a vote of 219 to 212. Obama signed the bill into law on March 23, 2010.<ref>{{cite news |url=https://www.nytimes.com/2010/03/24/health/policy/24health.html |title = Obama Signs Landmark Health Care Bill |date = March 23, 2010 |access-date = March 23, 2010 |newspaper = The New York Times |author = Stolberg, Sheryl Gay|archive-url=https://web.archive.org/web/20100325033529/http://www.nytimes.com/2010/03/24/health/policy/24health.html |archive-date = March 25, 2010 }}</ref>

The ACA includes [[Provisions of the Patient Protection and Affordable Care Act|health-related provisions]], most of which took effect in 2014, including expanding [[Medicaid]] eligibility for people making up to 133 percent{{spaces}}of the [[federal poverty level]] (FPL) starting in 2014,<ref name="cnn_ref1">{{cite news |last = Rice |first = Sabriya |url = http://www.cnn.com/2010/HEALTH/03/25/health.care.law.basics/index.html |title = 5 key things to remember about health care reform |publisher = CNN |date = March 25, 2010 |access-date = January 6, 2013 |archive-date = January 2, 2013 |archive-url = https://web.archive.org/web/20130102173326/http://www.cnn.com/2010/HEALTH/03/25/health.care.law.basics/index.html |url-status = live }}</ref> subsidizing insurance premiums for people making up to 400 percent{{spaces}}of the FPL ($88,000 for family of four in 2010) so their maximum "out-of-pocket" payment for annual premiums will be from 2 percent to 9.5 percent of income,<ref>{{cite news |last = Grier |first = Peter |url = http://www.csmonitor.com/USA/Politics/2010/0320/Health-care-reform-bill-101-Who-gets-subsidized-insurance |date = March 20, 2010 |title = Health Care Reform Bill 101 |newspaper = [[The Christian Science Monitor]] |access-date = July 5, 2015 |archive-date = July 6, 2015 |archive-url = https://web.archive.org/web/20150706014515/http://www.csmonitor.com/USA/Politics/2010/0320/Health-care-reform-bill-101-Who-gets-subsidized-insurance |url-status = live }}</ref> providing incentives for businesses to provide health care benefits, prohibiting denial of coverage and denial of claims based on pre-existing conditions, establishing [[health insurance exchange]]s, prohibiting annual coverage caps, and support for medical research. According to White House and CBO figures, the maximum share of income that enrollees would have to pay would vary depending on their income relative to the federal poverty level.<ref name="cbo_est">{{cite web |last = Elmendorf |first = Douglas W. |url=http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/107xx/doc10781/11-30-premiums.pdf |title = An Analysis of Health Insurance Premiums Under the Patient Protection and Affordable Care Act |publisher = Congressional Budget Office |date = November 30, 2009 |access-date = April 9, 2012 |archive-url = https://web.archive.org/web/20120227142305/http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/107xx/doc10781/11-30-premiums.pdf |archive-date = February 27, 2012 |url-status = live }}</ref>

[[File:Percentage of Individuals in the United States Without Health Insurance, 1963-2015.png|thumb|Percentage of Individuals in the United States without Health Insurance, 1963–2015 (Source: [[JAMA (journal)|JAMA]])<ref>{{cite journal|last1=Obama|first1=Barack|title=United States Health Care Reform|journal=JAMA|date=August 2, 2016|volume=316|issue=5|pages=525–532|doi=10.1001/jama.2016.9797|pmid=27400401|issn=0098-7484|pmc=5069435}}</ref>|alt=Graph showing significant decreases in uninsured rates after the creation of Medicare and Medicaid, and after the creation of Obamacare]]

The costs of these provisions are offset by taxes, fees, and cost-saving measures, such as new Medicare taxes for those in high-income [[tax bracket|brackets]], taxes on [[indoor tanning]], cuts to the [[Medicare Advantage]] program in favor of traditional Medicare, and fees on medical devices and pharmaceutical companies;<ref>{{Cite journal |last = Grier |first = Peter |date = March 21, 2010 |url = http://www.csmonitor.com/USA/Politics/2010/0321/Health-care-reform-bill-101-Who-will-pay-for-reform |title = Health care reform bill 101: Who will pay for reform? |journal = Christian Science Monitor |access-date = July 5, 2015 |archive-date = July 6, 2015 |archive-url = https://web.archive.org/web/20150706012138/http://www.csmonitor.com/USA/Politics/2010/0321/Health-care-reform-bill-101-Who-will-pay-for-reform |url-status = live }}</ref> there is also a tax penalty for those who do not obtain health insurance, unless they are exempt due to low income or other reasons.<ref>{{cite news |url=http://www.csmonitor.com/USA/Politics/2010/0319/Health-care-reform-bill-101-Who-must-buy-insurance |title = Health care reform bill 101: Who must buy insurance? |last = Grier |first = Peter |date = March 19, 2010 |work = [[The Christian Science Monitor]] |access-date = April 7, 2010 |archive-url=https://web.archive.org/web/20100405075157/http://www.csmonitor.com/USA/Politics/2010/0319/Health-care-reform-bill-101-Who-must-buy-insurance |archive-date = April 5, 2010 }}</ref> In March 2010, the CBO estimated that the net effect of both laws will be a reduction in the federal deficit by $143{{spaces}}billion over the first decade.<ref>{{cite web |last = Elmendorf |first = Douglas W. |title = H.R. 4872, Reconciliation Act of 2010 (Final Health Care Legislation) |date = March 20, 2010 |url = http://www.cbo.gov/publication/21351 |publisher = Congressional Budget Office |access-date = January 6, 2013 |archive-date = January 2, 2013 |archive-url = https://web.archive.org/web/20130102193615/http://www.cbo.gov/publication/21351 |url-status = live }}</ref>

The law faced several legal challenges, primarily based on the argument that an individual mandate requiring Americans to buy health insurance was unconstitutional. On June 28, 2012, the Supreme Court ruled by a 5–4 vote in ''[[National Federation of Independent Business v. Sebelius]]'' that the mandate was constitutional under the U.S. Congress's taxing authority.<ref name="WP-uphold">{{cite news |first = Robert |last = Barnes |url = https://www.washingtonpost.com/politics/supreme-court-to-rule-thursday-on-health-care-law/2012/06/28/gJQAarRm8V_story.html |title = Supreme Court upholds Obama health care overhaul by 5–4 vote, approving insurance requirement |date = June 28, 2012 |newspaper = The Washington Post |agency = Associated Press |access-date = June 29, 2012 |archive-date = June 28, 2012 |archive-url = https://web.archive.org/web/20120628232111/http://www.washingtonpost.com/politics/supreme-court-to-rule-thursday-on-health-care-law/2012/06/28/gJQAarRm8V_story.html |url-status = live }}</ref> In ''[[Burwell v. Hobby Lobby Stores, Inc.|Burwell v. Hobby Lobby]]'' the Court ruled that "closely-held" for-profit corporations could be exempt on religious grounds under the [[Religious Freedom Restoration Act]] from regulations adopted under the ACA that would have required them to pay for insurance that covered certain contraceptives. In June 2015, the Court ruled 6–3 in ''[[King v. Burwell]]'' that subsidies to help individuals and families purchase health insurance were authorized for those doing so on both the federal exchange and state exchanges, not only those purchasing plans "established by the State", as the statute reads.<ref>{{cite news|url=https://www.usnews.com/news/articles/2015/06/25/supreme-court-upholds-obamacare-subsidies-in-king-v-burwell |title=Supreme Court Upholds Obamacare Subsidies |first=Kimberly |last=Leonard |work=[[U.S. News & World Report]] |access-date=November 25, 2015 |url-status=dead |archive-url=https://web.archive.org/web/20160116072123/http://www.usnews.com/news/articles/2015/06/25/supreme-court-upholds-obamacare-subsidies-in-king-v-burwell |archive-date=January 16, 2016 }}</ref>