WASHINGTON 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 Partys legislative enemy No. 1.

And since President Barack Obama signed the health care measure into law on March 23, 2010, its troubled legislative history isnt close to being fully written.

Yet another Supreme Court case threatens to topple one of the laws main pillars, theres bipartisan support in Congress to eliminate the tax on medical devices one of the laws primary funding mechanisms and a slight majority of Americans still have negative views of the sprawling legislation.

But despite the political head winds, experts say Obamas legacy-defining law is quietly accomplishing the goals it was created to achieve.

The nations uninsured rate has plummeted as more Americans enroll in Medicaid or in federal and state marketplace coverage.

The laws consumer protections and insurance-benefit requirements have improved the quality of coverage for millions of people who get health insurance outside the workplace.

Premiums for marketplace health insurance have largely been reasonable and have increased only moderately thus far. Long-term cost estimates for providing coverage under the law have been falling.

Early Congressional Budget Office projections showed the law would trim the federal budget deficit by $124 billion from 2010 to 2019, while its repeal would increase the deficit by more than $100 billion from 2013 to 2022. The CBO cant update the laws projected impact on the deficit because of forecasting difficulties.

While its too soon to declare a summary judgment on the law, its early success usually would quiet most naysayers.

Most of the dire predictions made by the critics of the ACA have not come to pass, said Drew Altman, president and CEO of the Kaiser Family Foundation.

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