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Last month marked the four-year anniversary of the signing of the Patient Protection and Affordable Care Act of 2010 (PPACA), and 21 months since the Supreme Court upheld its constitutionality (with the caveat that states can opt out of the Medicaid expansion).  While all provisions of the law are not yet fully in place (total implementation won’t be complete until 2019), the big question is, what has happened?

The short answer is, a lot.  According to the Kaiser Family Foundation, 80 provisions have gone into effect between 2010 and 2014 (see Health Reform Implementation Timeline). Here is a . . .

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