The challenge of improving health care in America is a topic that has been addressed many times in the pages of the Journal of Law, Medicine & Ethics. The evergreen nature of the issue is largely due to the fact that while most of our country agrees that our health care “system” is profoundly broken, we vehemently disagree about how to fix it. The election of President Donald Trump in 2016 has not added clarity to the matter; while repeatedly vowing to destroy every last vestige of what he calls “Obamacare,” he has been singularly unable to do so, and thus the Affordable Care Act of 2010 remains the most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965.

To address this muddle of contradictory intentions, laws, and regulations, in 2017 this journal's parent organization, the American Society of Law, Medicine & Ethics joined with American University in Washington, D.C. to host Next Steps in Health Reform, a meeting of experts across multiple disciplines who attempted to tell us where we were in the process of reforming our loosely-defined “system” and to perhaps even fathom where we were going next. This conference was organized by the person at the center of the Venn diagram of ASLME and American University, AU law professor and current ASLME President Lindsay Wiley. Lindsay not only planned, organized, and hosted the conference at AU, but she also then edited the papers that came out of the conference, the collected edition of which you now hold in your hands. These papers attempt to identify the current state of health reform in America, as of 2017-2018. The authors include Sylvia Mathews Burwell, the secretary of the U.S. Department of Health and Human Services under President Obama and the current president of American University, Dan Hilferty, the CEO of Independence Health Group, former JLME guest-editors Sara Rosenbaum and Jeanne Lambrew, and a terrific lineup of experts in health reform, including many old friends and a few new faces.

It is our intention to make this conference and the accompanying special issue of JLME a biannual affair; plans are in motion to host this meeting again in 2019 with our great partner American University, with Lindsay at the helm. Surely, as this nation continues to fundamentally disagree about health care and how to make it available and affordable, especially to our most vulnerable citizens, enough material will be provided to fill many conferences and dozens of special issues. In the meantime, we invite you to enjoy this very special collection of articles, with all they tell us about our current state of affairs, from some of our favorite and most trusted authors.