Given the intensity of recent debates, it is clear that the Patient Protection and Affordable Care Act (ACA) is one of the most controversial legislative accomplishments in recent American history. But do we really understand the bill’s place in the annals of American policymaking? Beginning with proposals made by President Harry Truman, this presentation reviews the steps through which the ACA came to take its current shape. The speaker will explain how major policy developments—Medicare, Medicaid, Medicare Part D (Prescription Drugs) and the Children’s Health Insurance Plan, among others—were part of a long process culminating in the ACA. Along the way, the talk addresses failed attempts—especially those of Presidents Nixon and Clinton—to establish a national health care plan. The talk examines the political and cultural reception of health care reform to better understand the contemporary situation in which the ACA is being both applauded and criticized, and implemented as well as threatened with legislative repeal. Legal challenges to the ACA’s major provisions—especially the major Supreme Court case that upheld the ACA—will also be discussed. Finally, looking ahead, Health Care Reform 101: Understanding Obamacare considers the future of American health care reform.