President Obama’s greatest achievement and perhaps his
greatest failure is the same piece of legislation – Obamacare or, more
officially, the Affordable Care Act.
The intent of the ACA was ambitious: to provide health care
insurance for most of the 40 million Americans who had no coverage at all. Without health insurance, these people were
likely to be forced to accept inferior medical care.
This law has become they symbol of the failure of the Obama
administration and the cause of low ratings of Obama himself.
How did this come about?
It began with the adoption of the law itself. With control of the House and the 60 votes in
the Senate necessary to block a Republican filibuster, Democrats believed they
could pass almost any bill they wanted.
Still, they did not have enough support in their own party
for a single-payer system, used by most developed countries. But they could pass a bill that would improve
on a system in which health care providers could charge ever-higher prices and
insurers could pick who they would cover and set the premiums.
The result was an unusual hybrid system with both some
public elements and a continued role for the traditional players. And it would prove to cover millions more.
The bill shuttled back and forth between the House and
Senate. Secure in their belief they
could pass the bill on their own, the Democrats made no concessions to
Republicans, especially then Maine GOP Sen. Olympia Snowe, who had shown a
willingness to try to forge a compromise.
Then Massachusetts Sen. Ted Kennedy died and was replaced by
a Republican, eliminating the Democrats’ ability to block a GOP filibuster. The only way the bill could pass was by taking
the incomplete version already passed by the Senate but without any more House changes
and adopting it.
This virtually guaranteed Obamacare would become a bitter
issue between the two parties. The
mandate – the requirement for many people to purchase insurance or pay a
penalty – was opposed by all Republicans, though it had been a GOP idea a few
years earlier.
The situation was worsened by a combination of inaccurate
promises and poor promotion.
The president claimed the law, which almost certainly he had
not fully read, would allow people to keep their current coverage. That should have been true, but was not.
Its supporters also said it would not increase costs. Yet, how could Obamacare, which would insure
additional millions of people, cost no more than then current coverage?
These shortcomings were small compared to the complete
failure of the White House and the Democratic leadership to promote the
law. Beginning with the 2010
congressional elections, the GOP made Obamacare a national issue, while the
Democrats said nothing, mistakenly believing the elections would turn on local
issues.
The result was the issue belonged to the Republicans, and
the Democrats were continually fighting off attacks or trying to dodge them.
The debate over Obamacare finally came to set the tone of
the broader political debate in the country.
The Republicans could go from attacking the increased government role under
Obamacare to opposing the role of government across the board.
And just as with their failure to argue for Obamacare, the
Democrats have allowed themselves to be placed on the defensive, at best, or to
become anti-government GOP copycats, at worst.
Sen. Chuck Schumer, a part of the Senate Democratic
leadership, now says the whole idea was a mistake, and the Democrats should
have focused on other issues.
Jonathan Gruber, an economics professor and key player in
drafting the law, is now running off at the mouth about how clever he was in
fooling Americans about the very nature of insurance, in which premiums paid by
some people cover the costs of others.
If the Democrats refuse to be, well, Democrats, they will
continue to turn the government over to the Republicans. This year’s poor turnout in the congressional
elections was caused mainly by Democratic voters staying home.
The Democrats could propose the necessary measures to repair
Obamacare, even if the GOP refuses to adopt them. Merely trying to block repeal moves by the Republicans
or their friendly Supreme Court majority is not enough.
While the time has passed for offering spending measures to
cure every ill, the Democrats could be forthright in making the case for the
role of government. For example, roads
and bridges desperately need repair, and that takes government funds.
And, hopeless as it may seem, both parties should seek areas
for bipartisan action.