Sara Rosenbaum is the Harold and Jane Hirsh professor of health law and policy, and the founding chair of the department of health policy in the School of Public Health and Health Services.
On Oct. 1, five days from now, Americans will experience their first health insurance open enrollment period under the Affordable Care Act. This may seem inconsequential, but nothing could be further from the truth. 
Like that first day nearly 50 years ago, when older Americans began to enroll in Medicare, Oct. 1 represents a watershed in national health policy, especially for younger Americans who hopefully will be spared what their parents confronted both as they grew up and during their working lives.
Today, many GW students are insured through their parents’ health plans. They will be able to keep that coverage if they need it until they turn 26, thanks to the act. Our graduates will no longer face the prospect of going out into the world and finding that health insurance is either completely unaffordable or so skimpy that it’s not worth the price.
Even more importantly, our graduates will never face the prospect of being left completely uninsured because – ironically – of a health problem. Our graduates won’t have to think about passing up a fabulous job opportunity simply because it does not come with health benefits. All of these problems are a hallmark of our current national health insurance system – if one can call it that – which is about to sunset.
What will day one look like? No doubt it won’t be too pretty. A deluge of press accounts will report on what’s going wrong: Health Insurance Marketplaces – the linchpin of the new system – that aren’t yet displaying their information correctly; the challenge of understanding how the insurance plans being sold will work; the complexities of learning what coverage will cost and how to complete the enrollment process.
Even worse, we will begin to learn the consequences of the decision by more than 20 states – those with the poorest populations and the most to gain financially from health reform – to refuse federal funding to extend coverage for their poorest populations, an option created not by the act but by the Supreme Court’s health reform decision in 2012.
But give it time. As with all “new normals” in society, near-universal access to affordable health insurance coverage will become ingrained in American DNA. The early startup problems will ultimately abate, and marketplaces will begin to work smoothly. The millions of Americans who will use the Marketplace at some point in their lives will learn to navigate it with ease, and we all will become accustomed to always having access to health insurance regardless of where life takes us.
More fundamentally, what the U.S. will gain as a nation is the right to assume its place among other wealthy democracies that long have understood that their collective well-being depends in no small part on their ability to guarantee necessary health care to their populations, regardless of health status or personal wealth.
Americans deserve no less.
