The Patient Protection and Affordable Care Act signed by President Obama in March 2010 is a landmark in U.S. social legislation, and the Supreme Court's recent decision upholding the Act has ensured that it will remain the law of the land. The new law extends health insurance to nearly all Americans, fulfilling a century-long quest and bringing the United States to parity with other industrial nations. Affordable Care aims to control rapidly rising health care costs and promises to make the United States more equal, reversing four decades of rising disparities between the very rich and everyone else. Millions of people of modest means will gain new benefits and protections from insurance company abuses - and the tab will be paid by privileged corporations and the very rich. How did such a bold reform effort pass in a polity wracked by partisan divisions and intense lobbying by special interests? What does Affordable Care mean-and what comes next? In this updated edition of Health Care Reform and American Politics: What Everyone Needs to Know (R), Lawrence R. Jacobs and Theda Skocpol-two of the nation's leading experts on politics and health care policy-provide a concise and accessible overview. They explain the political battles of 2009 and 2010, highlighting White House strategies, the deals Democrats cut with interest groups, and the impact of agitation by Tea Partiers and progressives. Jacobs and Skocpol spell out what the new law can do for everyday Americans, what it will cost, and who will pay. In a new section, they also analyze the impact the Supreme Court ruling that upheld the law. Above all, they explain what comes next, as critical yet often behind-the-scenes battles rage over implementing reform nationally and in the fifty states. Affordable Care still faces challenges at the state level despite the Court ruling. But, like Social Security and Medicare, it could also gain strength and popularity as the majority of Americans learn what it can do for them.