Its come to be known as Obamacare . Sometimes it seems more like O-drama-care.

Nearly a decade has passed since Democrats first began promoting the initiative that eventually became the Affordable Care Act. And at no point has their effort to reform Americas dysfunctional health care system gone easily. Passing the law was a struggle, and then implementing it was, too.

Now there are new problems . Many of the nations largest insurers say they are losing big money on the policies they sell through the programs exchanges. Some of these companies have responded by jacking up rates . Others are dropping out of the markets altogether. Consumers who relied on these plans may have to pay more or switch plans next year, and they may not have many alternatives.

But the focus on whats going wrong with Obamacare makes it easy to lose sight of whats going right. The law has ended the insurance industrys most pernicious practices , fostered improvements in the way doctors and hospitals deliver care and brought the number of Americans without coverage to a historic low . Some state markets appear to be working just fine, and at least a few insurers are making money.

The laws achievements dont make the problems any less real. But they do put those problems into perspective and suggest that fixing them is worthwhile.

Obamacares Mounting Problems

One way to make sense of the latest news is to think about two recent reports one that spotlights the bad news and one that highlights the good. The first, which the Henry J. Kaiser Family Foundation conducted in conjunction with the Wall Street Journal , examines the exchanges and how many insurers have committed to offering plans through them. The exchanges are where people without access to employer coverage or public programs like Medicare can buy insurance, taking advantage of generous tax subsidies that vary based on income.