With the passage of the Patient Protection and Affordable Care Act (ACA) on March 23, 2010, preventing chronic disease and improving the health of the public became a centerpiece of health reform. Upheld largely by the Supreme Court on June 28, 2012, legislation and funding to ensure focused attention on prevention initiatives remain intact. The reelection of President Obama, the originator and prime supporter of the ACA, further solidified momentum for implementation of health care reform. Poised to expand health coverage and health services for all Americans, the ACA proposes changing a health care delivery system that limits access to care, compromises provision of quality services, increases costs as a result of system inefficiencies, and lacks attention to basic prevention and wellness supports.