The Journal of Law, Medicine & Ethics has a long and distinguished history of engagement with American presidential elections during my tenure as Editor. It began in 2004 when we were looking for an important symposium to feature the newly-designed JLME—the first aesthetic change in more than a decade. We eventually settled on “National Health Reform and America's Uninsured,” and asked the brilliant George Washington University scholar Sara Rosenbaum to edit the issue. Sara brought together an outstanding team of writers and researchers, the symposium became one of the most popular in the history of our publication, and the very cover of the issue (featuring the image of a man with a broken umbrella) became a symbol nearly synonymous with JLME.

We had now established a tradition: each presidential election year would feature an issue speculating on the next four years of health care and health reform in America. In 2008 Sara and Jeanne Lambrew presented, “On the Cusp: Insight and Perspectives on Health Reform,” which predicted many of the enormous changes enacted by President Obama's administration. Those changes were reviewed and discussed in our 2012 symposium, “Health Care Reform: Controversies in Ethics and Policy,” which was guest-edited by longtime friend of JLME Robert Sade. Bob and his team of authors anticipated many of the challenges that faced the Obama Administration in health policy over the last four years.

This year we have again teamed up with our friend Sara Rosen-baum, and together with her fellow guest editor Jane Hyatt Thorpe, we are proud to present, “Health Reform: Assessing the Affordable Care Act and Moving Forward.” As with our three previous issues, the papers in this symposium were written during the election year so as to be published within a few weeks of the November 2016 election. None of the papers in this symposium (or any of our past collections) dared hazard a guess as to whom might be elected president, but it was still somewhat of a surprise to many of our authors and editors when Donald J. Trump was elected. The results of the election, however, do nothing to dampen our enthusiasm for the importance of these collected papers. In fact, they remain an invaluable blueprint moving forward for how we, as a nation, can reinforce the strengths of healthcare in America while working together to fix the many parts of our system that remain almost inexplicably broken. Whether the new administration chooses to follow this blueprint is an open question, but that coming response does nothing to diminish the value of the papers contained herein. This symposium is a vital look at where healthcare is in America today, and where it needs to go tomorrow. We will see if that path is followed.