Health Care for All

One year ago today, President Obama signed the Patient Protection and Affordable Care Act into law – and the focus of attention immediately turned to the states. Now, one year later, as millions of women, seniors, children, and small businesses are seeing benefits from provisions in the law that have already taken effect, it is even more clear that the states are the venues where the future shape of the law will be decided.

Despite a year of sustained attacks from the opposition, almost all states continue to move forward with implementation of the health care law. Even as the right continues to spew rhetoric attempting to strike down the law, over 20 states are moving forward with active exchange legislation. As the time remaining for states to implement effective exchanges grows shorter, and as an effort to give states more freedom to design their own systems gained White House support this week, progressive models are emerging for building state-based marketplaces that ensure the health security of families.

The Patient Protection and Affordable Care Act has been the topic of heated political debate since becoming the law of the land almost one year ago. As right-wing calls for repeal continue to make headlines, many positive and popular provisions of the law are already benefiting families across the nation. Working-class and middle- class families have seen their health security increased by provisions that rein in insurance industry abuses and expand coverage, making it less likely that they will lose their savings due to an illness or injury, or be unable to afford needed treatments. But as the curtain draws on the first year of the life of the Affordable Care Act, what happens in the second year at the state level may prove to be even more critical to its ultimate fate.

This week, the new leadership of the House of Representatives made good on their campaign promise to bring repeal of the health law up for a vote as their first legislative priority of the 111th Congress. The House passed HR 2 without proposing anything to take its place, despite the repeal effort facing certain failure in the Senate.