I used to be back within the crowded East Room of the White House on Thursday, as I used to be 13 years ago, this time standing under a portrait of first first lady Martha Washington, when President Joe Biden entered for a lunchtime event focused on the Reasonably priced Care Act.

The room looked much similar to it did on March 23, 2010, after I had rushed over to the White House to witness President Barack Obama signing his historic health bill into law. I knew from that moment — standing under a portrait of President Teddy Roosevelt, who was the primary chief executive to espouse a necessity for national health insurance — that my life as a health journalist would never be the identical.

Yet, when Biden scheduled an event to commemorate the thirteenth anniversary of the health law, I used to be unsure of the necessity to keep commemorating its birthday.

In spite of everything, on the thirteenth anniversary of President Lyndon Johnson signing Medicare and Medicaid into law — July 30, 1978 — the Democratic president within the White House didn’t hold an event to commemorate the date when tens of hundreds of thousands of older Americans and lower-income people gained coverage. Then-President Jimmy Carter spent that Sunday at Camp David.

But with the ACA in 2010, after a century of debate, the U.S. health system was getting hit with a thunderbolt that will enable hundreds of thousands of individuals to realize medical coverage. The law made many changes affecting hospitals, doctors, insurers, drugmakers, and employers in an effort to live as much as its lofty name by lowering costs.

Those sweeping provisions, the years spent implementing them, and efforts by Republicans and the courts to repeal or change the law have kept the Reasonably priced Care Act within the news for even longer than I had anticipated. After 13 years, the job remains to be not done. North Carolina on Thursday became the fortieth state to expand Medicaid under the ACA.

Biden used the health law anniversary to tout the law’s influence. He reminded his audience that Republicans still need to strip a lot of its advantages. He also stressed that the country has unfinished business to lower drug costs for a lot of and expand health coverage to individuals who still haven’t got it. Indeed, greater than 2 million individuals are without coverage within the 10 states — highly populous Florida and Texas amongst them — which have yet to expand Medicaid.

Many former Obama staffers who helped get the law passed were there — including some who work within the Biden White House. (Obama was not there.) So, too, were several Democratic lawmakers who helped pass the law, including former House speaker Nancy Pelosi and former California congressman and now Health and Human Services Secretary Xavier Becerra.

“Look, 13 years ago today, we gathered on this room as President Obama signed into law the Reasonably priced Health Care Act,” Biden began along with his remarks. “Hard to consider 13 days ag- — 13 years ago. It looks like 13 days ago.”

“And I remember the three words I used on the time,” he said as many within the audience recalled the swear word he was caught whispering to Obama via a live microphone. “I believed it was. I believed it was an enormous deal. And I stand by the actual fact it was an enormous deal.”

Biden said that the health law has been called by many names, but that probably the most appropriate is Obamacare.

The law has grow to be ingrained into the material of the country, Biden said. Over 40 million Americans are covered by Medicaid or online insurance marketplace plans, the best on record, the Biden administration said Thursday. That is a 36% increase from 2021.

But a thirteenth anniversary celebration? Jessica Altman, who helped implement Obamacare within the Obama administration and is now CEO of Covered California, one in every of the Obamacare exchanges, said it was necessary to take time to remind people what the American health system used to appear to be in addition to the various challenges remaining to enhance it. (Altman is the daughter of KFF’s president and CEO. KHN is an editorially independent program of KFF.)

“We still have places to go, and we still have work to do and the people in that room are excited to maintain doing it,” Altman said.