What if Obamacare never happened? 7 answers

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Remember the holiday film classic “It’s a Wonderful Life,” in which an angel helps businessman George Bailey appreciate what life would have been like had he never been born?

To mark the fifth anniversary of President Barack Obama’s historic health reform legislation, we posed a similar scenario to three health experts.

What would life be like without the Affordable Care Act, or ACA? It’s not a completely abstract question, given that the law’s fate is now in the hands of the U.S. Supreme Court for a second time.

Much different world from 5 years ago

Without the law, signed by the president on March 23, 2010, tens of millions would still be uninsured, says Rachel Klein, director of organizational strategy for the health care consumer group Families USA. “It completely changed the landscape of health insurance coverage in the individual market.”

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Dr. Peter McGough, medical director for the University of Washington Neighborhood Clinics in Seattle, agrees. “I’ve seen the impact, not only in my clinic, but across our 10 clinics.”

Gerald Kominski, who directs UCLA’s Center for Health Policy Research, adds: “It established national standards in health insurance markets, a bar that many states were not meeting.”

Here are seven ways the Affordable Care Act transformed American health insurance.