System failure: Obama and Park, October 2013.
Pete Souza / White House

President Barack Obama has often said that his proudest domestic achievement is the passage of the Patient Protection and Affordable Care Act (commonly known as the ACA or Obamacare). The sprawling law, pushed through Congress in 2010 in the face of fierce Republican resistance, made numerous important changes to the U.S. health-care system -- a system so big that, on its own, it represents an economy about the size of France’s.

Thanks to the ACA, which took effect on January 1 of this year, the U.S. government has finally joined most other industrialized nations in offering its citizens health security. The reform, by many estimates, will save tens of thousands of lives as Americans reap the benefits of such provisions as greatly expanded preventive medicine and a prohibition on insurance companies’ discriminating against those with preexisting conditions. The era when millions of Americans were bankrupted by medical expenses will

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  • JONATHAN ALTER was a longtime columnist and editor at Newsweek and is the author, most recently, of The Center Holds: Obama and His Enemies.
  • More By Jonathan Alter