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When President Barack Obama signed the Affordable Care Act five years ago, he visualized a time when the political hyperbole would be silenced and ordinary people would see that the health care law improved their lives. The White House ceremony on March 23, 2010, was an applause-filled celebration. "When I sign this bill," Obama said, "all of the overheated rhetoric over reform will finally confront the reality of reform." (Alonso-Zaldivar, 3/22)

With more than 50 congressional repeal votes, a near-death Supreme Court experience and a botched marketplace debut to its credit, the Affordable Care Act has had a tortured five-year existence as the Republican Party’s legislative enemy No. 1. And since President Barack Obama signed the health care measure into law on March 23, 2010, its troubled legislative history isn’t close to being fully written. (Pugh, 3/20)

More than 90 new health-care companies employing as many as 6,200 people have been created in the U.S. since Obamacare became law, a level of entrepreneurial activity that participants say may be unprecedented for the industry. (Wayne, 3/20)

Challenges remain, including another court case that could unravel a key part of the law. But regardless of future problems, Obama’s signature domestic achievement has already left its footprint on the health care sector. Designed to expand access to affordable health insurance, curb the cost of care and make Americans healthier, the law has probably irreversibly changed how consumers interact with the industry. (Shapiro, 3/22)