The Affordable Care Act (ACA) is a landmark health bill signed into law by President Barack Obama in 2010. The law mandates universal healthcare coverage for all Americans, and requires massive shifts in the way healthcare is practiced in the US. Among those changes, doctors will be reimbursed based on the quality of care that they provide, as opposed to receiving a set fee for the services they provide. The ACA mandates large shifts in the IT infrastructure of healthcare as well. The ACA has met fierce criticism and worked its way up to the Supreme Court, which ultimately upheld its constitutionality.