The 2010 law has been in play almost since it was passed. Several provisions are already in effect, including one allowing children to be covered on their parents' policy until age 26, and another preventing insurers from denying coverage for pre-existing illnesses.
These are popular aspects of the plan, and no wonder: It was a disgrace that children were kicked off of plans at a younger age and that Americans could not get health insurance because of pre-existing conditions.
Still, we have been critical of the measure's flaws, including the number of waivers that have been granted, but mostly because it didn't do enough to control the rising costs of health care. That's at least as critical an issue as covering the uninsured, which the law also does.
Americans pay more for health care than citizens of any other developed country and for outcomes that are only mediocre. That fact, alone, cried out for health reform.
Those indisputable facts required two responses: improving quality and controlling costs. The new law may help improve quality, though many health professionals and insurers were already pursuing that goal on their own. But it does little to control costs.
Health care is approaching 20 percent of gross domestic product and is on track to reach 22 percent by 2038, meaning that 22 percent of all money spent will be for health care. That is unsustainable. Covering tens of millions of the nation's uninsured is a worthy goal for the Affordable Care Act, but if costs aren't contained, what good will it do, anyway?
Still, the plan is here and, if Obama and Democrats have their way -- which seems likely -- it is here to stay. That means New Yorkers and other Americans need to get on board.
The plan's health exchanges, which provide information about available private-sector health care plans, are immune to the federal government shutdown. The exchanges will help uninsured Americans purchase the health insurance that the new law requires. Subsidies will be available according to the income levels of purchasers.
The requirement has been an especially controversial part of the plan, and for obvious reasons. It is rare that government compels Americans to purchase anything, though it is not unheard of, automobile insurance being possibly the most obvious example.
This could have been a much better bill than it is. That would have required Republicans to do more than try to deep-six it and Democrats to have been open to compromises. But Repub-licans weren't interested in producing a better plan and while Democrats did compromise -- dropping their preference for a "public option" -- there is no telling how open they would have been to an engaged Republican influence.
So, this is what we have for now. The law has its benefits and flaws and its consequences for those who ignore its requirement to carry health insurance. New Yorkers who need insurance and want to explore their options can go to www.nystateofhealth.ny.gov.
-- The Buffalo News