The state of the 10-year-old Affordable Care Act is the subject of a new article by Public Policy Professor Mark A. Peterson in a special two-issue publication of the Journal of Health Politics, Policy and Law. The advance publication of Peterson’s study, “The ACA a Decade In: Resilience, Impact, and Vulnerabilities,” is included in the first issue of the Duke University Press journal. Peterson, former editor of the journal, writes that in the decade since its enactment, the political health of the ACA — popularly known as Obamacare — has looked precarious. “It decidedly lacked the popular acclaim of the sort that arose to undergird programs like Social Security and Medicare,” Peterson says, but he adds that it has remained “viable and consequential despite Republican efforts to end it.” He also points out that, while the impact on insurance coverage has been substantial, it remains distant from universal coverage. “The ACA has revealed perhaps surprising resilience, put insurance cards into the hands of millions previously outside the system, and even contributed to some degree of reduced financial burdens,” Peterson argues. “At the same time, all of these gains have been incomplete, remain vulnerable and are threatened by underlying forces in the political economy.” Assessing the strengths and vulnerabilities of the act in its first 10 years, Peterson cautions that a path to a more secure future for either the ACA — or a more ambitious successor — is far from clear.