To get around the snag, the Democrats pulled what some thought of as pretty hefty trickery by not bringing the legislation back to the Senate, even though the two chambers had passed different bills, then they used the Senate's bill as the core for a "reconciliation vote" and passed it in March 2010.
A few days later, Joe Biden called it a big deal.
Not So Fast!
Some newly-elected Republican governors weren't happy with ObamaCare (a term, by the way, that Obama has embraced), so they decided not to "implement" it in their states. Also, a bunch of Republican attorneys general from typically conservative states have taken issue with the "individual mandate" in the law, and they've taken the issue to court.
The question is whether the "mandate" is constitutional. The law's supporters say it's not a mandate at all — instead it's a choice: either buy insurance or pay a tax. Critics say that means it's a mandate, and mandates aren't allowed in the Constitution.
The Supreme Court is going to determine who is right.
"In order for the challengers to win, they would have to show that it is not a tax," says Jack Balkin, a constitutional law professor at Yale. "Most people think that the law will be upheld, but the Supreme Court will decide."
The monster that is the health care debate has ravaged the political scene for four years. Every Republican presidential candidate says he would repeal ObamaCare as soon as possible. And the public still doesn't know if the law is good or bad, because it won't take effect for years.
Obama gave a big speech to a joint session of Congress, just as Bill Clinton did, in which he laid out his promises for his health care plan. "Now that we're basically at the 2-year anniversary," said Kate Nix, a policy analyst at the conservative Heritage Foundation, "a lot of those promises aren't going to come true."
One reason that the health care debate was so acrimonious is that it erupted during a period of heightened government control. The Bush administration had just bailed out the banks, and Americans were confused why the jobs of the people who had caused the financial crisis were saved, while the rest of the country spun into unemployment.
Obama also wanted to bail out another industry — car makers. And on top of all of that, he passed a massive spending program called the "stimulus plan" that critics then said would do nothing and now say didn't do much.
Health care sponsored by the government wasn't exactly what most Americans wanted in their personal lives.
"The timing of it stirred up the emotions around it a lot," Tanner said. "I think people looked at it and said, 'Whoa — where are we going?' "