On Friday, the roused American public triumphed over a willfully vicious and stubbornly ignorant mugging of the nation’s health insurance system. Republicans retreated in disarray from the Party’s multi-year campaign to repeal the Affordable Care Act of 2010.
The Trumpcare debacle has its political* roots in Republicans’ public pledge to derail any and every initiative advanced by President Obama, from the moment he was elected in 2008:
“… before President Obama even took office, Senator Mitch McConnell, Republican minority leader, had a strategy for his party: use his extensive knowledge of Senate procedure to slow things down, ...and deny Democrats any Republican support on big legislation.”
While the U.S. two-party system stokes competitive rivalry, Obama-era Republicans were distinct and transparent in prioritizing politics over policy. They aimed to win controlling majorities in both houses of Congress as soon as the election of 2010, and to resume power in the White House in 2012. Accordingly, Republicans alternately boycotted and opposed Obama’s signature campaign to pass historic legislation that would reverse the alarming increases in uninsured Americans, and control increasingly unaffordable health care costs.
Congress approved the Affordable Care Act of 2010 (the ACA), creating and funding an historic expansion of secure coverage for health care, phased in over the next few years. Immediately, the ACA wiped out discriminatory “pre-existing condition” exclusions that private insurance plans used to avoid paying up for enrollees who actually got sick, and guaranteed that privately insured people could continue to cover their dependents through age 26. It expanded eligibility for low-income people through the public Medicaid program. President Obama was re-elected in 2012. In 2014, the ACA began providing subsidies to moderate-income people to buy private insurance through newly created exchanges. It reduced the number of uninsured from 48.6 million Americans in 2010 to 27.3 million in 2016, down from 16% of the American population in 2010 to 8.6% in 2016.
For 7 years, Republicans worked to undermine the ACA’s cost controls, and to limit insurance coverage. They willfully bellowed non-stop against “Obamacare” for implementing the most basic principles of business insurance. They fumed against requiring that we all chip in for some basic health care services even when we don’t need them, because someday we all – or a family member - certainly will, charging that it amounts to communism, tyranny by Washington, a basic abomination of Freedom, and a bribe to the undeserving to vote for Democrats. From 2010 to 2014 Congress voted more than 50 times to repeal Obamacare, efforts Obama routinely vetoed.
Republicans perpetuated the lie that the ACA imposes a mandate to send off all enrollees to virtual death camps at a certain age (one member of Congress insisted at a recently televised town hall meeting that this language, or something close to it, is literally written into the law).
During a 2016 Presidential campaign that challenged many Americans’ common understanding of reality, to say nothing of democracy and justice, Donald Trump pledged his first act as President would be to “immediately repeal and replace Obamacare….We have to do it…and we will do it very, very quickly.”
Turns out, despite the non-stop trial repeal votes that started in 2010, at the moment of nearly absolute power in 2017, the Republican leaders in Congress and President Trump couldn’t pull off a repeal.
Many enrollees in ACA exchange plans who had also voted for Trump began to realize that repealing the ACA would likely transform Republican rhetorical lies into a dangerous truth: they would be among the millions of Americans losing their health care coverage, and life-saving coverage for family members. Word got out that the Republican bill planned to transfer savings from slashing their benefits, to insurance moguls and the mega-wealthy.
A roused electorate, many connected to or mobilized by grass-roots groups like MoveOn and Indivisible, swarmed Congress’ phone lines and town hall meetings, furiously opposed to proposals to cut subsidies for insurance, and funds for Medicare and Medicaid.
At the same time, even the Republicans couldn’t figure out how to design an insurance system that doesn’t look something like an insurance system. (Again: Insurance collects funds from many people to cover the risk of a member needing costly health care, inevitable for all but unpredictably timed for any individual.) Thus they couldn’t convince enough of the Kool-Aid drinkers in the Freedom Caucus that health insurance is not by definition a violation of each individual’s liberty, including the God-given duty to compete for the basic necessities for existence. In the end, 33 Republicans from opposite ends of the political spectrum refused to support the repeal bill; House Speaker Paul Ryan called it quits.
After 7 years, the partisan-driven campaign to repeal and replace Obamacare is attempting to slither away into thin air, exposed for the Riches To The Rich scam it always was.
Friday’s heartening victory belongs squarely to the energized American public. We deserve time to celebrate. But there are still too many people who can’t afford health care.* Having demonstrated that they are clueless + on the wrong side on health care, the Trump crew vows to move on to tax reform. We know we’ll have to stay riled up, and get even more united, vocal and organized, to win social justice, or even a better ACA.
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* There are well-known policy reasons for unaffordable health care in the U.S. Publicly financed health care systems, some known as “single payer,” exist in most other industrialized countries, providing universal coverage for high quality care, while controlling expenditures. Several members of the U.S. Congress support single payer legislation to expand public financing for health care, including Sen. Bernie Sanders. Topic for another blog.