On March 23, 2010, the Patient Protection and Affordable Care Act (PPACA) placed into law comprehensive health insurance reforms that will hold insurance companies more accountable, lower health care costs, guarantee more health care choices and enhance the quality of health care for all Americans. The law is intended to provide greater access to quality affordable healthcare for all Americans. To reconcile and amend PPACA, the Health Care and Education Reconciliation Act of 2010 was signed into law on March 30, 2010. The law includes the Student Aid and Fiscal Responsibility Act, which was attached as a rider.