By Evan Falchuk

The President is out on the road promoting (again) the health care reform plan passed by Congress a few months ago.

Now that it’s been a few months, we can step back and ask: what really happened?

The short answer: on the big issues, not very much.

For those who hoped (or worried) the reform plan was a government take over of American health care, it’s not.

For those who worried (or hoped) the plan would create new competition in the health insurance market, it won’t.

For those who hoped (or worried) it would reduce the cost of health care, it won’t do much.

For those who hoped it would finally end the problem of the uninsured, it won’t.

So what will it do?

You could create a giant laundry list of the many, many different things tucked away in the reform law (here’s a good resource for that).  But this really isn’t the point.

A couple of months ago I was at one of those closed-door conferences where major employers talk about what they really think about health care.  One of the speakers was an old-time Washington health care policy hand, having been closely involved health care reform since the Nixon Administration.  His view?  Reform is a giant laundry list because that’s how we “do” big important things in the United States.  Congress and the President try to take advantage of any running room they have to pass a law, and, knowing that the moment will pass, try to put in as much as they possibly can.  Of course, part of this process leads to conflicting strategies, watered-down changes, gaps in policy and a built-in process of decades of regulatory interpretation.

Look, for example, at ERISA.  First passed in 1974 to address problems in the market for employee benefits and pensions, the law continues to this very day – nearly 40 years later – to be the subject of significant interpretation, reinterpretation and amendment.  Over time, it’s become part of the ordinary fabric of American life, even if there are few people who remember why it was passed in the first place, or what controversy there were around it those decades ago.

It’s like this with the the health care reform law.  It will be the source of controversy and interpretations for the next several decades.  Is it smart for the President to promote the law as solving big problems when in fact it’s just part of the beginning of a decades-long process?  I’ll defer to his political judgment.

But what I can say for sure is this, as I noted way back last year:

It’s reform, American style.