President Obama signed the Affordable Health Care for America Act into law on Tuesday, beginning a sweeping overhaul of the nation's $2.5 trillion health care system. He was surrounded by House Speaker Nancy Pelosi, Senate Democratic Leader Harry Reid, the wife and son of the late Senator Ted Kennedy, an early proponent of a national health insurance program, and many other lawmakers who devoted the past year to getting a health care reform bill passed.
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There was an air of celebration at the White House leading up to the historic signing ceremony, with a Marine pianist playing, legislators chatting, and cameras flashing as attendees captured the moment. Not everyone, however, is excited about the new legislation; the bill passed the House on Sunday by a vote of 219-212 and many Republicans are already working on measures to repeal the bill. The bill will certainly be a major factor in midterm elections this fall. The Democrats were only able to come up with enough votes to pass the bill after President Obama issued an executive order clarifying that no taxpayer money will be used for abortions.

If the efforts to repeal the health care bill fail, it will be enacted to provide coverage to an estimated 30 million Americans who are currently uninsured. It will require that most Americans have health insurance, and will give Medicaid coverage to an additional 16 million people.

Some of the more immediate provisions to go into effect include allowing adult dependent children to remain on their parents' insurance policies until the age of 26, prohibiting states from cutting back their existing Medicaid and Children's Health Insurance Program coverage, barring insurance companies from excluding children with pre-existing conditions, making "freestanding birth centers" eligible for Medicaid payments, and requiring the secretary of health and human services establish criteria “for determining whether health insurance issuers and employment-based health plans have discouraged an individual from remaining enrolled in prior coverage based on that individual’s health status.”

Standing at over 2400 pages long, the Senate bill is confusing to most Americans, and even many lawmakers don't know all of the exact provisions and when various provisions will be implemented. The signing of the bill was a major victory for the Obama administration—President Obama declared that this was a more important victory to him than winning the presidency, as it will bring real, concrete change to the lives of Americans—but there are still months, even years of work ahead to ensure that the President's vision for health care reform is realized.