Reporting from Washington — President Obama visited Wednesday with Americans who are benefiting from the new healthcare law as he marked the passage six months ago of the landmark legislation and worked to repulse an escalating Republican attack on the sweeping overhaul.
"When I came into office, obviously we were confronted with an historic crisis," Obama told a small gathering in the backyard of a Virginia man who suffers from hemophilia and hit a lifetime limit in his health coverage.
But offering a blunt defense of the healthcare law, Obama said he had to do more than confront the nation's economic woes.
"Healthcare was one of those issues that we could no longer ignore….We said we have to take this on," he said, citing stories of people going bankrupt because of their medical bills.
"We are now actually able to provide some help to the American people," he said.
Though many of the most sweeping benefits of the law do not go into effect for years, millions of consumers stand to gain substantial new protections starting this fall. (The benefits apply to plan years starting Thursday or later, although because many Americans' health plans renew in January, they may not see these until then.)
Insurance companies will be prohibited from canceling policies when customers get sick, or denying coverage to sick children.
The law will allow parents to keep their adult children up to age 26 on their family plans and will bar insurers from placing lifetime caps on how much they will pay when their customers get ill.
And many consumers will get new rights to appeal claims that are denied by insurers and win new access to preventive care without having to be asked for co-pays.
"There are many meaningful reforms here that, while not perfect, will help millions of consumers get a fairer shake when they buy and use health insurance," said Jim Guest, president and CEO of Consumers Union, the nonprofit publisher of Consumer Reports.
Many more substatial changes, including new guarantees that all Americans can get ceoverage and millions of dollars of subsidies to them pay their premiums, will go into effect in 2014.
Other changes have already started, such as new tax breaks for small businesses and the gradual phase-out of the coverage gap in the Medicare Part D drug benefit.
But public misunderstanding about the new law remains very high, fueled in part by Republican attacks on the law.
A recent survey by the nonprofit Kaiser Family Foundation found that nearly half of the country's seniors believe erroneously that the law creates a new government panel to make decisions about end-of-life care for people on Medicare.
"The messaging wars and the rhetoric are really muddying the picture," said Mollyann Brodie, who oversees the Kaiser poll.
That has complicated efforts by the Obama administration and by consumer and patient advocates to convince a wary electorate to back the law. Close to half the country opposes the new law, according to most polls.
The White House Wednesday again tried to sell it by surrounding the president with Americans who are benefiting from the law, including several small-business owners who plan to use the tax credits and seniors who have received $250 rebate checks to help them with their prescription drug bills.
Wednesday morning, Obama also met with state insurance commissioners whom the administration is counting on to protect consumers from excessive rate hikes by insurance companies.
And the White House unveiled a new health website, http://www.whitehouse.gov/healthreform, that highlights stories from around the country of the law's effect.
"These things are designed not to have government more involved in healthcare," Obama said Wednesday. "They're designed to make sure that you have basic protections in your interactions with your insurance company, that you're getting what you paid for, that you have some basic measures of protection."
The president faces a difficult task.
Republican lawmakers, energized by their brightening political prospects, are staking out plans to roll back parts of the law should they take control of Congress next year.
On Wednesday, Wyoming Sen. Mike Enzi, the senior Republican on the Senate health committee, called for senators to back his resolution criticizing a provision of the law designed to discourage businesses from scaling back health benefits.
The provision would place new requirements on health plans provided by employers, such as providing free preventive care, if employers substantially raise co-pays, deductibles or other employee contributions.
"The administration's grandfather rule is a job-killing, wage-cutting game changer for small business," Enzi said. "This is not the kind of reform the people wanted."
On Thursday, Republican leaders are expected to outline more detailed plans for repealing other parts of the law when they unveil their much-anticipated governing agenda.