Pelosi at Aspen Ideas Festival to Celebrate 15 Years of the Affordable Care Act: "This was the challenge of our generation."
Aspen, CO – Yesterday, Speaker Emerita Nancy Pelosi joined former U.S. Health and Human Services Secretaries Kathleen Sebelius and Sylvia Burwell at the Aspen Ideas Festival for a behind-the-scenes look at the passage of the Affordable Care Act, moderated by former Congressman Charlie Dent.
The conversation, hosted by the Aspen Institute, offered an inside look into one of the most consequential legislative efforts in American history, focusing on the intense political landscape in 2010, the stakes for working families and the coalition it took to get the ACA across the finish line.
"For a hundred years they’d been trying to pass a [health care] bill," Speaker Emerita Nancy Pelosi said. "This was the challenge of our generation—to do something very special for the American people that made a difference in their lives."
The panel recounted both the triumphs and trials of the legislative fight, including the instrumental leadership of Secretaries Sebelius and Burwell in its passage and implementation, efforts to prevent Republicans from repealing the ACA, and the ongoing fight to protect Medicaid from Republican attacks.
Watch the full event HERE.
Read coverage of the event below:
The Aspen Daily News: Pelosi talks Affordable Care Act in Aspen
[Rick Carroll, 6/23/25]
Rep. Nancy Pelosi stuck to the script at Paepcke Auditorium on Sunday night. In Aspen for a panel discussion, Pelosi joined the stage with three others to discuss their roles in the passage of the Affordable Care Act, which became law in 2010.
The conversation was titled “Behind the Vote: How the ACA Became Law.” Likely due to its irrelevancy to the discussion, there was no mention of the United States’ strikes on three nuclear sites in Iran a day earlier.
Pelosi was critical of President Donald Trump’s decision to bomb the facilities on Saturday night. On X, she posted: “Tonight, the President ignored the Constitution by unilaterally engaging our military without Congressional authorization. I join my colleagues in demanding answers from the Administration on this operation which endangers American lives and risks further escalation and dangerous destabilization of the region.”
On Sunday, however, the discussion of the landmark legislation — also known as Obamacare and considered the largest piece of health-care legislation in the U.S. since the introduction of Medicare and Medicaid in 1965 — took center stage.
Noting that it took a century of wrangling, Pelosi said it was President Bill Clinton’s administration that gave a serious push to start health care reform in his first term starting in 1993. Facing strong opposition from conservatives and the insurance lobby, Clinton couldn’t pass it through.
“For over 100 years, presidents had been trying to pass, to provide … some kind of health care for all Americans,” Pelosi said. “The Clintons had attempted and it may have not succeeded in terms of passing the bill, but it certainly succeeded in raising the awareness and making it possible for us to pass a bill later. So I just give them credit for that.”
Pelosi, a House member since 1987, was speaker from 2007 to 2011 and from 2019 to 2023.
As speaker of the House, she played a key role in shepherding the ACA bill through a divided Congress and a Republican party fiercely opposed to the legislation. She also had to negotiate with those in her party, from the progressives to the moderates, over concessions in the bill. Even without a single vote from a Republican in either chamber of Congress, the ACA became law in March 2010.
The legislation made health coverage more accessible to people with low to moderate incomes or pre-existing conditions by giving them income-based subsidies. Its supporters also say the ACA stabilized the health-care market by making it more equitable and accessible.
The ACA’s backlash, however, has included insurers leaving marketplaces in rural areas, fewer choices for doctors because of insurers tightening their provider networks, increased premiums for middle-class consumers, as well as public confusion over navigating a system rife with complexities.
Pelosi was joined on the panel by Kathleen Sebelius and Sylvia Burwell, the respective 21st and 22nd U.S. Secretaries of Health and Human Services, and former Republican Rep. Charlie Dent of Pennsylvania.