Health reform has gotten more than a little beaten up over the past year.  The lies – from government take-over to death panels – somehow persevere, regardless of how many times they are exposed for the falsehoods that they are.  The fear-mongering, the hyperbole – how it is that half the people in the United States don’t even know that the law is still the law?  No doubt, opposition to health reform has been louder than its support.

But in quiet corners of America, people are finding answers in the health reform law, which turns one year old this week.

I posted on Facebook that the White House asked me if I had any positive stories of health reform.  Not that I needed help because I have plenty of positive stories, people who are better off today than they would have been without health reform.  But my message on Facebook brought even more: 

· Mary’s daughter was denied health insurance because she has attention deficit disorder.  Due to health reform’s prohibition against pre-existing condition exclusions for children to age 19, she now is insured. 

· Linda, who has diabetes and went for years without insurance, finally got enrolled in the new Pre-existing Condition Insurance Plan and has affordable insurance for the first time in her memory. 

· Melanie needed a heart transplant, but her insurance had a cap on benefits of$200,000.  That changed due to health reform, which eliminated lifetime caps and is phasing out annual caps on benefits.

· Miriam, who also has a pre-existing condition, had aged out of her parent’s policy at age 19 because she was not a full-time student.  Due to health reform, she was able to get back on her parent’s plan until she turns age 26.

In only one year, the pieces of health reform that have taken effect have made a tremendous difference in people’s lives.  In the years to come, the law will entirely eliminate pre-existing condition exclusions, create marketplaces where consumers can comparison shop for a plan, greatly improve the process whereby consumers can appeal insurers’ denials of coverage, require insurers to spend 80 or 85 percent of premium dollars on things that improve health rather than on administrative costs (i.e., salaries and bonuses), close the “doughnut hole” or coverage gap for seniors whose prescription drugs are covered by Medicare.  These are all wonderful things that will benefit millions of Americans.

Is the health reform law perfect?  No more than Medicare or Social Security was perfect when passed.  You don’t reform an entire industry in one fell swoop and expect perfection.  All of us who have worked hard to support the passage and implementation of health reform have known from day one that there would be changes made down the road, as we saw how various pieces of the puzzle play out. 

For example, waivers have been granted in certain circumstances to ensure stability in the insurance market in the time leading up to full implementation in 2014.  This is not a sign that there’s something wrong with the law; this is a sign that the law was designed to be flexible enough to accommodate the needs of different sized insurers in different states.

And to be perfectly clear, the law represents health insurance reform, not health care reform.  It gets a lot more people covered, but it doesn’t do enough to control escalating health care costs.  More work is needed.  Again, though, that doesn’t negate the value of the work that’s already been done.  For the people we serve, all of whom have pre-existing conditions, just the elimination of pre-existing condition exclusions is a profound improvement on the status quo.

And measured against the status quo before health reform was passed, there is no question that things are better.  Mary, Linda, Melanie and Miriam all confirm that fact with their stories, along with the thousands of other stories of success that could be told.  The job we started out to do is not finished, and it won’t be until we can do a lot more about health care costs.  But health reform is a critical first step. 

And so we celebrate, as we did one year ago, with the belief that health reform is working already, and things will only keep getting better.

Jennifer C. Jaff, Esq. is the Founder and Executive Director of Advocacy for Patients with Chronic Illness, Inc.