 A study by Bilikisu Elewonibi and Rhonda BeLue found that overall CAM usage is more likely with health insurance coverage, the latter of which tends to be less common among immigrants.On March 23, 2010, the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama.This legislation, joined with the Health Care and Education Reconciliation Act of 2010, seeks to expand coverage and improve access to the health care system while simultaneously managing its costs.