Happy birthday, health care reform!

West Virgina residents celebrate the first birth day of the Affordable Care Act. WV Senator Jay Rockefeller was guest of honor, but my picture of him didn't turn out so good.

I never really planned my life this way--not that I'm a huge believer in planning a life--but I've spent over 20 years working on health care issues. Not all the time, thank God, but here and there as threats or opportunities arose.

In several union struggles I tried to support, as far back as 1989, health care for active workers and retirees was a major factor. In the late 1990s, lots of folks here joined to support the state Children's Health Insurance Program, and we've worked to expand it ever since. Then there were efforts to improve or defend the state's Medicaid program.

All the while, though, in the back of my mind and the minds of many others the main goal was achieving universal health care. Yesterday, March 23 2011, marked the first anniversary of the passage of the Patient Protect and Affordable Care Act, referred to hereafter as the ACA. In Charleston, over 100 people gathered to celebrate this milestone.

Let me be the first to say that the act we got wasn't exactly the one I had in mind. The Gentle Reader may have noticed the sometimes vast difference between what one wants and what one gets. Of the different versions of reform kicked around since 2009, I liked the federal House version a bit better than the Senate's. I was disappointed that the public option was eventually dropped. But still, I worked as hard as I could to support the bill we had and would do it all again.

Of course, there was a price to pay in the form of a backlash and a well-funded campaign of misinformation. But one year later, the real benefits are starting to kick in for people in West Virginia and around the country. And West Virginia's senators, including the late great Robert C. Byrd and especially Jay Rockefeller, played a major role in its passage.

The West Virginia legislature, in a session that kind of drove me crazy, did at least take the major step this time around of creating a state insurance exchange, which will lay the basis for major reforms and expansions of care that will happen in 2014.

For all its warts, the Affordable Care Act is already reaching millions of Americans and will reach far more when fully implemented. If it survives, it will be a landmark piece of legislation. In fact, future generations may well wonder why it took so long for a country like the USA to get there.

In the meantime, we need to work to defend it and aid in its implementation.

BIG LIES. Robert Reich takes on deliberate misconceptions about job creation and job killing.

WOULD YOU BELIEVE dog therapy for law students?

URGENT AMAZONIAN FISH MANURE UPDATE here.

GOAT ROPE ADVISORY LEVEL: ELEVATED