01/15/2013 11:54 am ET Updated Mar 17, 2013

Health Reform Law Has Withstood Minor 'Damage' Since 2010

President Barack Obama's health care reform law has been through an awful lot since it was conceived in the halls of Congress during 2009 and 2010. More than 30 repeal votes in the Republican-controlled House. A Supreme Court challenge. Mitt Romney and the 2012 election.

Despite all that -- and barring a colossal failure in the meantime -- Obamacare will be providing coverage to millions of people by this time next year.

Though the health reform law has withstood its greatest threats, it's taken some "damage" along the way, notes John McDonough in the Boston Globe. McDonough, a health care reform expert if there ever were one, helpfully lays out what he calls the "holes" drilled into the Affordable Care Act, also known as the ACA, since its enactment.

Many assume that partisan gridlock on Capitol Hill has blocked Congress from altering the ACA, and they are mistaken. ... By my count, (and please let me know what I have missed) there have been eight consequential, substantive changes to the ACA since its signing in March 2010.

Number one on McDonough's list, appropriately, is the Supreme Court ruling that upheld health care reform but allowed states to undermine its goal of extending Medicaid coverage to more poor people. Chief Justice John Roberts handed states the right to refuse the Medicaid expansion and 10 Republican governors have jumped at the opportunity so far.

The real value of McDonough's post, though, is his summary of the other, lesser-known modifications made to the health care reform law over the last three years, such as cuts in funding for preventive medicine and community health centers.

McDonough has a special perspective when it comes to health care reform. He was a senior aide to Sen. Ted Kennedy (D-Mass.) during the congressional debate. Before that, McDonough was a key player in the Massachusetts health care reform effort as executive director of Health Care For All. McDonough even used to be a Massachusetts state legislator. He also authored the exhaustive book Inside National Health Reform.

Read McDonough's whole post for all the details.