For many social workers, the March 2010 enactment of the Patient Protection and Affordable Care Act (PPACA) (EL. 111-148)--later amended to include EL. 111-152, the Health Care and Education Reconciliation Act of 2010--was a bittersweet moment. Bitter because it was less than many of us had wanted. For years, NASW had advocated a single-payer system, which the president and congressional leaders rejected from the beginning. During the debate over reform, NASW supported a strong public option, which was not included in the final legislation. Yet, despite this, the bill's enactment was, as NASW (2010b) put it (in response to enactment of the House bills, H.R. 3590 and H.R. 4872), "a monumental legislative achievement of our time" and "a significant step toward a comprehensive and universal health care system for our nation." Although this battle was successful, the "war" over health care reform is far from over (Aaron & Reischauer, 2010). Polls have found mixed support for the legislation and confusion about its content and potential effects on various groups (Kaiser Family Foundation, 2010a). In several states, legislators have introduced bills challenging aspects of the legislation, particularly the mandate requiring individuals to buy health insurance, and others have scheduled ballot referendums to determine whether citizens can refuse to comply with the legislation (Cauchi, 2010). In addition, several state attorneys general have brought suit against the law (Lazarus & Morrison, 2010). Opponents of reform "pledged to make" it and "the procedures used to enact it" an issue in the 2010 elections (Aaron & Reischauer, 2010).