President Barack Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010. The Affordable Care Act and the Health Care and Education Affordability Reconciliation Act of 2010, which amended the first piece of legislation (and was signed into law on March 30, 2010) made up the health reform package of 2010. The law focuses on reform of the private health insurance market; provides health insurance coverage for some 30 million uninsured; includes more guarantees for those with pre-existing conditions; allows young adults to stay on their parents' health coverage longer; and improves prescription drug coverage under Medicare. Some changes took effect upon the law's enactment, but the bulk of the provisions—including expansion of Medicaid eligibility and implementation of state health insurance exchanges—do not take effect until 2014 and beyond. Critics of the law cite its complexity, the federal government's new roles in the healthcare market, enactment without a single Republican vote, its overall cost and minimal cost-control provisions, prompting calls for repeal and replacement of the Affordable Care Act from the moment it was signed.