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Eleven years of the Affordable Care Act

By Valerie Jarrett, President, The Barack Obama Foundation

11 years ago today, President Obama signed the Affordable Care Act (ACA) into law. What I remember most about that week is standing on the Truman Balcony the night the ACA passed, listening to the President explain why that moment meant more to him than the night he was elected.

Watch this video to hear for yourself:

President Obama shares why the night the ACA passed meant more to him than election night

Today, the impact of the ACA is well established: more than 20 million more Americans have received health insurance coverage, people with pre-existing conditions do not have to worry about paying higher premiums or being denied coverage, insurance companies may no longer limit coverage with annual or lifetime caps, young adults have the right to stay on their parents’ insurance until age 26, women can no longer be charged more for insurance than men, essential women’s health services are guaranteed, and nearly 40 states have expanded Medicaid, allowing millions of low-income Americans access to health care.

But looking back, it’s easy to forget just how broken our health insurance system was before the Affordable Care Act. As a candidate in 2008, President Obama heard story after story from Americans who had been denied insurance based on “pre-existing conditions” like asthma, diabetes, cancer, heart disease, even pregnancy. He met uninsured people who were forced to declare bankruptcy due to health care debt and Americans who had insurance but quickly hit the lifetime cap on their coverage after becoming sick. He came to the White House determined to deliver for those families.

President Obama signs the Affordable Care Act in front of a group of people with various skin tones and ages.

President Barack Obama with Vice President Joe Biden, Members of Congress and special guests, signs the health insurance reform bill in the East Room of the White House, March 23, 2010. (Courtesy Barack Obama Library)

The odds were against him — seven previous presidents had tried and failed to pass a national health insurance program. But he wasn’t alone; the White House was backed by a movement and Democratic Congressional majority determined to make sure this time was different — a coalition of union members, local advocates, members of Congress, and even ordinary people.

One of those people was Natoma Canfield, an Ohio woman who wrote the president a letter about how she was unable to afford health insurance due to a pre-existing condition. Natoma became the face of the ACA debate when President Obama read her letter to a group of insurance executives to make the case for why we needed to act now. He held a rally in her hometown and Natoma’s story helped persuade her local member of Congress to vote for the bill. He hung Natoma’s letter in the Oval Office as a reminder of why he was fighting so hard for reform.

A letter from Natoma Canfield, a woman from Ohio that President Barack Obama met who didn’t have health insurance, hangs on the wall in the hall between the Oval Office and the President's Private Office in the West Wing, June 28, 2012. (Official White Hou

The framed letter from Natoma Canfield, 2012. (Courtesy Barack Obama Library)

The story of the ACA is an example of one that will be told in the Obama Presidential Center Museum, where we will highlight Americans like Natoma who helped shape the Obama presidency, while inspiring visitors to make change in their own communities.

But the work to expand healthcare didn’t end with the passage of the ACA. Over ten years later, leaders at the federal, state, and local level are still pushing for progress. That’s why we’re so proud to support people like Kealoha Fox, one of our 200 Asia-Pacific Leaders, who is working to provide free health care to Hawaiians living in poverty, particularly indigenous communities.

Kealoha Fox smiles to camera.

We hope you’ll join us in helping to build the Center, and making sure leaders like Kealoha have the support they need to carry the baton that has been passed to her.