This Supplemental Issues of the Journal of Health Care for the Poor and Underserved (JHCPU) celebrates the 25th year of the journal’s publication. The theme for this issue is the “Patient Protection and Affordable Care Act” (PPACA), the landmark health reform legislation that was signed into law by President Obama in March of 2010, and in the broadest of terms upheld by the Supreme Court in the Spring of 2013. This theme is timely and relevant given the original and current focus for this scholarly publication on the medically underserved and the intent of the legislation, among other areas, to provide health insurance for millions of uninsured and underinsured in the Nation.