Ten years ago, it took a monumental effort to pass the ACA, or Obamacare. As a result, today, no American is denied health insurance because of a pre-existing medical condition, and 20 million people who previously lacked coverage now have it.

On this episode of The Dose, The Commonwealth Fund’s Liz Fowler, who was one of the key architects of Obamacare, talks about the behind-the-scenes effort it took to get the law passed.