Happy 10th, Affordable Care Act!

Happy 10th birthday, Affordable Care Act! Here's a blog post I wrote at the time President Obama signed it into law:

It's official. President Obama signed the health care reform bill into law yesterday.

He told those in attendance that

We have just now enshrined, as soon as I sign this bill, the core principle that everybody should have some basic security when it comes to their health care.

Critics of the bill may point out that this isn't exactly the case, but there's no denying that this is a landmark piece of legislation that will extend health coverage to millions who have been doing without it. The New York Times calls it

the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago.

It remains to be seen whether the immediate benefits (political and otherwise) will outweigh the blowback. This item from Politico argues that the former will come before the latter, but I'm not sure I agree. It always seemed to me that a major drawback of the legislation was that the major expansion of health coverage via Medicaid and subsidies won't hit until several years down the line, meaning that the risks might hit earlier than the benefits.

Still, it probably will be hard for those who want to repeal it to win much of a crowd by saying "Bring back the donut hole" for Medicare Part D, or "let's cut those young people off their parent's insurance" or "Bring back denials of coverage for pre-existing conditions!"

The game has changed, although it's hard to guess just how or how much.