U.S. President Joe Biden holds holds onto notes while arriving to speak at a 'Help is Here' tour event to tout the 1.9 trillion American Rescue Plan Act law on the 11th anniversary of the Patient Protection and Affordable Care Act (Obamacare) legislation being signed into law, during a visit to the James Cancer Hospital and Solove Research Institute in Columbus, Ohio, U.S., March 23, 2021. REUTERS/Leah Millis