WASHINGTON -- One year later, Nancy-Ann DeParle can understand why Americans are still sharply divided over whether health care reform was a good idea.
"For many of them, the benefits of the new law are just beginning to be felt," said DeParle, who was President Barack Obama's point person on health reform.
But for those who are already seeing the benefits, such as young adults who can now stay on their parents' insurance plans until they turn 26, the reforms already have proven their worth, DeParle said.
"If you talk to somebody whose child just graduated from college and doesn't have health insurance, I can tell you they're happy," she said. "I've had a number of them come up to me in church and various other places to say, 'Thank you for helping my child to be able to stay on my plan until they're 26.' "
One year ago on March 23, Obama signed the historic health reforms into law, putting in place the most sweeping changes to the nation's health delivery system since the creation of Medicare more than four decades ago.
The reforms, which are being phased in, mandate that just about every American buy health insurance, guarantee coverage for 32 million uninsured people and bar certain insurance company practices, such as charging women higher premiums or refusing to provide coverage for people with pre-existing conditions.
Though many of the changes won't kick in until 2014, the Obama administration says the law already is helping millions of people.
Medicare recipients can now receive free preventive services such as mammograms and colonoscopies. Seniors who hit the prescription drug coverage gap known as the "donut hole" received $250 tax-free rebates last year and will be eligible for a 50 percent discount on brand-name prescription drugs when they hit the gap this year. An estimated 4 million small businesses are eligible for up to $40 billion in tax credits to offset the costs of buying coverage for their employees.
Yet after a year on the books, health reform remains bitterly divisive for much of the country.
The new Republican majority in the House voted in January to repeal the reforms, a decision that was largely symbolic since a similar repeal movement later failed in the Senate, which is still controlled by Democrats. Regardless, Republicans say they will try to unravel the law by refusing to allocate money to carry out the reforms.
"There is not a thinking person in Washington who believes this health care law will work as designed because it doesn't solve the biggest problem in our health care system, which is cost," said Sen. Bob Corker, R-Tenn.
"In fact," Corker said, "the law increases federal health care spending, despite record deficits and debt, and imposes a huge unfunded mandate on state governments to expand their Medicaid programs."
The law is also under attack in the courts.
Twenty-six states have filed legal challenges to the reforms. Two federal judges have ruled the law is unconstitutional because of its mandate that virtually every American buy health insurance. Three other federal judges have ruled in favor of the law, all but assuring it will end up before the U.S. Supreme Court.
DeParle, who helped write the law as head of the White House Office of Health Care Reform and is now Obama's deputy chief of staff, said the administration believes the courts eventually will uphold the law.
DeParle disputed Republican arguments the reforms are causing health insurance premiums to rise. To the contrary, she said, evidence suggests the law may be helping keep rates down in California, Ohio and Connecticut, where state insurance commissioners have ordered actuarial reviews of proposed rate increases and concluded they were unjustified.
Contact Scripps Howard News Service reporter Michael Collins at collinsm(at)shns.com