The debate over the Affordable Care Act and the subsequent expansion of America’s Medicaid system continues. "Obamacare," is a substantial law passed by Congress that introduced major reforms in America's healthcare system for the first time in decades. A new survey released by the University of Alabama at Birmingham Lister Hill Center for Health Policy states that a majority of Alabamians oppose the Affordable Care Act but nearly two-thirds believe the state should expand Medicaid. In Alabama and 22 other states, Medicaid expansion is one of the key parts of Obamacare that these states have declined to incorporate. The law still continues to be the subject of opposition and attempted repeals following the Supreme Court's decision. However, the majority of the Affordable Care Act will begin to take effect at the start of 2014. Final portions will be phased in until complete in 2020.