Since I was elected to Congress, I’ve been hearing from many groups and organizations who have been preparing for the launch of the Affordable Care Act for years. They have reached out to explain how the Affordable Care Act works for them, and how it doesn’t.

I have heard from health care providers and practitioners, our farmers and farmworkers, unions, and businesses both large and small. In each case, I have listened and tried to be helpful.

Up until Oct. 1, though, when open enrollment for individuals began, the American people only understood the broad strokes of how the legislation would affect them.

What a difference a few weeks makes!

The American people are beginning to understand and to experience firsthand the rollout of one of the biggest overhauls of our health care system in decades. I’ve now heard from thousands of you and the stories are as unique as the individual.

My constituents have expressed their views about the troubled launch of the federal website, the relatively smooth rollout of the Covered California marketplace, the insurance cancellation notices in their mailboxes, and how — despite having pre-existing conditions — many of you are able to get coverage for the first time.

A doctor from Ventura wrote to tell me that in one day, she saw three patients who are chronically ill and were afraid to seek medical care because they do not have health insurance. However, because of the Affordable Care Act, they will be eligible for coverage on Jan. 1.

A couple from Camarillo who are in their early 60s have been told by their insurer that their current plan is being canceled and that the new Bronze plan — from the same insurer and with the same deductible — will cost them $600 per month more because they are not eligible for premium subsidies.

Clearly, the legislation is working for some and not for others.

We certainly know from experience that whenever you introduce a big program, it takes time to implement. When Social Security, Medicare, Medicaid and Medicare Part D (the Medicare prescription drug program) were introduced, they too had issues that needed to be addressed. But Congress came together to improve those programs and now they enjoy broad support from the American public.

The fact is, when it came to health care, we needed reform. We simply could not continue down the path we were headed. With the No. 1 cause of bankruptcies being from individuals and families shattered by a catastrophic illness, to small and large businesses having greater and greater difficulty staying open or being able to compete in a global economy, because of double-digit annual increases in health care costs, the status quo simply could not be sustained.

So in 2010, a Democrat-controlled Congress passed, and President Obama signed into law, an overhaul of our health care system that was based on an architecture developed for years by the Heritage Foundation — a conservative think tank — which was implemented to generally good reviews in Massachusetts by then-Gov. and future Republican presidential candidate Mitt Romney.

I will be the first one to admit it’s not perfect. While it helps millions, it doesn’t help everyone. While it bends the cost curve for so many Americans, it does not for many others. The enrollment systems put in place by the federal government are not working as they should, while in many states they are working reasonably well.

We cannot address these issues by going back to what we had before, nor can we take rigid or ideological positions against making changes going forward. We need to listen to our constituents, as I am listening to mine, and we need to make the adjustments necessary so that our health care system works for all Americans. It’s a big challenge, but America has never shied away from big challenges in the past. It cannot do so now.

For those of you who have reached out to me to tell me your personal stories, thank you. For those of you who have not, I encourage you to do so. It is with these stories that I can best advocate for our community in Congress.


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