Celebrating the First Anniversary of the Signing of the Affordable Care Act



[by Karen Metcalf]

In preparing for the celebration of the first anniversary of the signing of the Patient Protection and Affordable Care Act (Affordable Care Act, ACA), I found myself reflecting that those of us who support the law seem to have missed something in our messaging.  We seem to have become so caught up in the individual “trees,” the discreet benefits of the law, that we haven’t given enough emphasis to the great “forest” within which those trees are taking root and growing.  

We have created a catalog of benefits–$250 rebate on prescription drugs for seniors in the doughnut hole, high risk insurance pools for the uninsured with pre-existing conditions, etc.–and we have ended up including “insurance coverage for 32 million more people in 2014” as just another element in that list.  But it is not, and should not be treated as, co-equal with all the other benefits.  In fact, this enormous expansion of coverage is broadening the membership in the “club” of the insured, and I believe the effects of that expansion will have a deep impact–for the better–on our country.

I hope that the comments I delivered to honor that anniversary (below) will help others to understand why we must give this achievement the recognition and praise that it deserves.

Remarks on the First Anniversary of the Signing of the Affordable Care Act

St. John’s Lutheran Church, Rock Island, Illinois
March 23, 2011

Do we not all have eyes?  Do we not all have “hands, organs, dimensions, senses, affections, passions?  Fed with the same food, hurt with the same weapons, subject to the same diseases, healed by the same means . . .?”

The truth of our common humanity that underlies Shylock’s rhetorical questions hasn’t changed in the 400+ years since those words were written—except for the last part.  “Healed by the same means” is not necessarily true in this country today.  We know it has been estimated that the number of uninsured adults under 64 who die prematurely every year is perhaps 45,000 higher than it would have been, if they had had insurance.  We know that people who are uninsured often forego preventive care.  We know they often delay seeing a health care professional because of the cost—which means that the range of treatment options, the “healing means,” is often more limited than the range of options available to those who are insured and seek treatment earlier.  Until the passage of the Affordable Care Act one year ago today, that situation was worsening every year, and there was no hope in sight.

But now, under the ACA, in 2014 the number of uninsured Americans will decrease by approximately 32 million people, many of whom have been without coverage for years.  As Shakespeare says, they are “subject to the same diseases,” but because so many in this country have lacked health insurance, the course of those diseases has not always been the same for everyone.

So, we’re here today to celebrate the first anniversary of this historic legislation.  There is much to celebrate, some of which will be covered by others on the program.  But let’s remember first and foremost what it will mean for millions in this nation who, until last year, have lived without—and sometimes died because they lacked–the simple security of having health insurance.  Expanding coverage to another 32 MILLION people is an over-arching and monumental achievement that we must not lose sight of in our thinking and public discourse.

As implementation of the law moves forward, with new protections from insurance company abuses, our country will move beyond what has been the situation for too many, for so long—an individual person, or family, or small business having little or no power to challenge premium increases, to find affordable alternatives, to avoid medical bankruptcy.  Those days are coming to an end, and we will all share the protections of the law—whether we change employers, lose our jobs, even go into business for ourselves; and, whether we are healthy or become ill. So I celebrate the signing of the ACA.

I also want to celebrate all the people who helped create this more secure future.  Yes, that includes many of our elected officials–at the national level, of course—but also in state legislatures and city halls.  To them I say, “Thank you.”  I also want to thank all the local people in the Quad Cities community who not only cared, but took action:  they attended public meetings, signed petitions, wrote letters, shared their stories—and nearly 7,000 of them contributed their handprints to raise awareness of the injustice of people dying because of a public policy that left them uninsured and thus isolated and vulnerable.  Vulnerable to disease, vulnerable to enormous medical expenses—and vulnerable to fear of both.

So, THANK YOU TO ALL OF YOU.  You know who you are.  We have a great community team.  Now, because of the efforts of so many people, we finally have a framework, a structure on which we can build an inclusive—not exclusive—system of health care security.

Today we are celebrating the first year of this new approach, and we are celebrating all the people who knew deep down inside that health care reform was the right thing to do.  Over time, this law will help us all to understand a little better that we all have a stake in each other’s health and well-being—that truly, No Man—or Woman—is an Island.  So this law makes me feel proud, because I believe that it is grounded in the best part of the American character: our essential respect for others and our generosity of spirit.  

But the work of building this new system isn’t done. So after I have some coffee and cake, I plan to roll up my sleeves and get on with the job.  There’s still plenty of work for everyone.  

native of St. Louis and a graduate of Cornell College in Mt. Vernon,
Karen Metcalf has been working on health care reform since 2003,
when she learned that an estimated 18,000 people die every year in this
country because they lack health insurance.  Although her background is
non-medical, she is married to a pediatrician who trained in Britain
and Canada and practiced in Canada for many years before they moved to
the Quad Cities in 1994.  Since their move, they have been studying,
discussing, and writing about the American health care “system,”
drawing upon their experience in all three countries where they have

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