In a year that included an attempted House repeal of the federal health care law, several court cases challenging its constitutionality and Republican candidate debates proposing a replacement plan, it can be difficult to dig through the rhetoric to determine just what the 2010 health care law has done.
The 2,400-page document and a multiyear and multistep implementation don't help with the confusion. Proponents and foes say big pieces of the law have been enacted and have already affected millions of people's lives.
"It's complicated, but there are very many benefits affecting millions of people," said Don Berwick, who served as administrator of the Centers for Medicare and Medicaid Services until the beginning of December. "They will not know it's the Affordable Care Act, but it is."
In 2011, the law targeted specific groups of people — mostly the young and senior citizens — while the most argued about pieces won't come until 2014. Then, assuming the Supreme Court doesn't rule against the "individual mandate," the provision that requires most Americans to buy health insurance, millions more people will be affected.
Health insurance exchanges for people who don't receive insurance through their employers will start working as Medicaid expands through federal funding to include more people who can't afford insurance. Lower-income Americans will receive help paying their premiums.
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