Provisions in the patient protection and affordable care act ppaca health care issues costs and access jan 05 2021 posted by roald dahl media publishing text id 11024757b online pdf ebook epub library upheld the constitutionality of the patient protection and affordable care act ppaca first enacted in 2010 provides the patient protection and affordable care act ppaca pl 111. The following summary of the provisions in the patient protection and affordable care act is based on ppaca summaries from thomaslocgov and dpcsenategov and is fact checked for accuracy against the law itself the patient protection and affordable care act hr390 in some cases additional rules have changed parts of the law. The affordable care act aca is divided into 10 titles and contains provisions that became effective immediately 90 days after enactment and six months after enactment as well as provisions phased in through to 2020 below are some of the key provisions of the aca for simplicity the amendments in the health care and education reconciliation act of 2010 are integrated into this timeline . Legislation the patient protection and affordable care act ppaca pl 111 148 as passed by the senate on december 24 2009 and by the house of representatives on march 21 2010 1 the act contains numerous provisions affecting medicare payments payment rules covered benefits