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Health Reform Cover
The April 5, 2010, cover of TIME Cover Credit: PHOTO-ILLUSTRATION BY ANN ELLIOTT CUTTING FOR TIME. INSET: BRYCE DUFFY FOR TIME.

'We Need to Get This Right': Obamacare Turns Five

Mar 23, 2015

When President Obama signed the Affordable Care Act on March 23, 2010, it was obvious that making "Obamacare" official was still only the beginning of the law's story. "Now for the really hard part," TIME proclaimed in a cover story about the new law.

Looking back at that story by Karen Tumulty and Kate Pickert that announced the law's arrival, it's noteworthy just how tempered expectations were.

As TIME explained:

Economists and health care experts have long agreed on the problems that ail the health insurance system in America. It leaves too many people out. Even those who have coverage may be one diagnosis away from financial catastrophe. On the other side of that same equation lie the waste and excess created by paying doctors and hospitals for the quantity of treatment they provide rather than what works best. By some estimates, as much as 30% of the more than $2 trillion Americans spend on health care each year goes toward treatments that are unnecessary and even harmful. And what does the U.S. get for that staggering investment? Shining hospitals packed with cutting-edge technology but also a population whose health and life expectancy lag behind those of most other industrialized democracies.

Will these reforms turn all that around? We won’t know for years, probably not for decades. The most ambitious element of the new health care law--the expansion of coverage to an additional 32 million Americans--won’t even take effect until 2014. “It’ll take four years to implement fully many of these reforms because we need to implement them responsibly,” Obama said as he prepared to sign the legislation. “We need to get this right.”

The charts that accompanied the 2010 story included predictions for 2019. There number of uninsured Americans was predicted to drop by 28 million — from 50 million at the time of publication, to 22 million — during that time. If those changes happened steadily over the intervening nine years, about 15 and a half million Americans would have gained insurance in the first five years.

Just last week, the Department of Health and Human Services announced that about 16.4 million previously uninsured people have already gained insurance since the law was passed.

Read TIME's 2010 cover story about the new health-care law, here in the TIME Vault: What Health Care Means for You

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