In recent months, President Obama and administration officials have dashed across the nation trumpeting the two-year anniversary of the Affordable Care Act (ACA), also known as Obamacare — a title the administration has embraced as of late. In his rhetoric, the president has revisited the most prominent theme of his 2008 campaign for the presidency: change. As evidence of change you could, in fact, believe in, the president cited the 2010 health care law repeatedly. Its sweeping patient protections and regulation of an out-of-control insurance industry will increase quality, access and affordability of health care in the United States — substantive reform of medicine for the U.S. public according to the president.

To examine Obama’s claim, one must recall the state of health care in the United States just two years ago. Reviewing the changes already made and those still to come from Obamacare, the law’s opponents have a difficult case to make.

Before the signing of the ACA, those with a pre-existing condition such as heart disease or other chronic illnesses were often out of luck when seeking health insurance. Insurance companies commonly denied these individuals coverage or canceled it once the illness developed and the patients needed coverage most. Even if the patient maintained coverage, insurance companies often cut off payments after the patient reached an annual or lifetime coverage limit. Furthermore, the stresses on the U.S. health care system go deeper than simple insurance industry abuses. With the cost of insurance so high, young adults frequently opted to go without insurance, leaving themselves vulnerable to unexpected bills they were unable to pay. After all, who really anticipates a car crash and several weeks in an intensive care unit? Those unpaid costs end up on everyone else’s tab. The Affordable Care Act ends discriminatory industry practices and solves the latter problem by allowing dependents to stay on the health insurance plan of their parents until they are 26.

Since the signing of the health reform law, the industry abuses noted above have ended. No longer can insurance companies discriminate against individuals for pre-existing conditions or for getting sick — choices over which the patients had no control. Insurance companies cannot impose annual or lifetime limits on the amount of coverage you receive. And, perhaps most significantly, insurers must now spend 80-85 percent of premiums on medical care rather than on fattening company profits. The law also requires new insurance plans to cover basic health screenings and vaccines to prevent illnesses or treat them early rather than allow common infections to lead to costly visits to the emergency room. None of this was true prior to Obama signing the ACA into law.

In addition to the sweeping regulations above, a whopping 2.5 million young Americans have been added to the insurance rolls according to the Department of Health and Human Services since the ACA allows young people to remain on their parents’ insurance until age 26. The benefits of this change are felt close to home at the University where health insurance is a requirement for enrollment. How many first-year students were not hit with an additional costly expense for an Aetna student health plan because they were able to stay on their parents’ insurance?

Not only does that provision give 2.5 million young people access to health care, it reduces the likelihood one of them cannot pay an unexpected medical bill and has to pass the cost on to the rest of us. Further, the law offers health security at a time when young people often switch jobs and careers and do not maintain consistent coverage through their employers. Opponents of the law cannot ignore these substantial changes in U.S. health care.

One must not only consider the above facts when debating the changes made by the Affordable Care Act but also must appreciate the historical struggle to pass national reform. Progressives spent nearly a century trying to pass universal health care legislation. Until now, the insurance industry won. The pharmaceutical industry won. Special interests, other than the patient, always won out over substantive reform of health care. With the Affordable Care Act, all of that changed. Patients won. Sweeping rules were put in place to hold insurers accountable, to expand coverage, to increase access to care and revamp the health care system in the United States. That sounds like the change I believed in.