President Obama was sworn into office at the height of the Great Recession, the greatest global recession since the Great Depression of the 1930s. The recession began in the United States with a crisis related to subprime mortgages and speculative investment vehicles tied to those mortgages. Within a month, Obama signed into law the American Recovery and Reinvestment Act of 2009, providing nearly $800 billion in government stimulus spending. Within a few months, the government set aside trillions more to buy up distressed real estate assets and to rescue failing automobile manufacturers. By June of 2009, the National Bureau of Economic Research declared the recession over, though it would take much longer for the economy to recover. By the end of Obama's presidency, the unemployment rate had dropped from a high of nearly 10 percent to 4.7 percent.
By the end of his second year in office, President Obama achieved the most comprehensive reform of the American health system since the expansion of Medicare and Medicaid under President Johnson. At the time of its passage, the so-called Patient Protection and Affordable Care Act (PPACA), quickly dubbed "Obamacare", expanded coverage to 24 million of the 50 million Americans without insurance, and was scored by the Congressional Budget Office as reducing the federal debt over ten years. Ironically, Obamacare incorporated Republican-backed elements that had succeeded under Governor Mitt Romney in Massachusett's health care plan. It included a requirement for individuals to have health insurance--the individual mandate--that was first proposed by Republican Senator Orrin Hatch in 1993 as an alternative to the health care reforms proposed by the Clinton administration. Tragically, the fact that the ACA included elements that had Republican support in other times and places did not prevent the initiative from falling prey to a prolonged and comprehensive attack by Republicans in Congress. The plan hurt small businesses, was poorly implemented in many ways, and was opposed by a massive health care lobby newly empowered by the Supreme Court's relaxation of lobbying restrictions (Citizens United v. FEC). Though consistently supported by a plurality of Americans, the law provoked a massive backlash that led to the Republicans regaining control of Congress. Rather than fixing its flaws, Congress has largely gutted the law in the eight years since its passage.