Amid covid-19, the potential overturn of Roe v. Wade, and a war in Europe, the Affordable Care Act has been flying under the radar in 2022. But this will be a pivotal year for the federal health law. Unless Congress acts, millions of Americans could see their costs for coverage rise dramatically as expanded subsidies expire. At the same time, the end of the public health emergency could boost the uninsured rate as states disenroll people from Medicaid. Peter Lee, who recently stepped down as the first executive director of the largest state-run ACA insurance marketplace, Covered California, has thought long and hard about how the ACA came to be, how it’s been implemented, and what should happen to it now. He joins host and KHN chief Washington correspondent Julie Rovner for a wide-ranging discussion on the state of the ACA.