On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, and subsequent amendments under the Health Care Education and Reconciliation Act of 2010, collectively referred to as the Affordable Care Act (ACA).

The U.S. Department of Health and Human Services is the primary federal agency responsible for Affordable Care Act (ACA) implementation. Within U.S. Department of Health and Human Services, the Centers for Medicare and Medicaid Services (CMS) oversee the major coverage provisions related to the Health Insurance Exchanges, Medicaid, the Children's Health Insurance Program (CHIP), and private insurance reforms. The Center for Consumer Information and Insurance Oversight (CCIIO) and the Center for Medicaid and CHIP Services (CMCS) are the two centers within CMS with primary implementing authority.

The Departments of Treasury and Labor also hold ACA implementation responsibility.