It has been three and a half years since President Obama signed into law the Patient Protection and Affordable Care Act (now commonly known as Obamacare). No other piece of legislation has experienced such a torturous path to implementation. Other major social policy changes – such as Social Security, Medicaid, Medicare, food stamps, and the Children’s Health Insurance Program (CHIP) – all were acknowledged as the law of the land once passed by Congress and signed by the president.
But not Obamacare. Immediately after its passage, opponents challenged Obamacare in federal courts. The U.S. Supreme Court nixed forcing the states to expand Medicaid, but they upheld most of Obamacare. The law wasn’t unconstitutional after all.
Then, all the Republican presidential candidates, including Mitt Romney, campaigned against Obamacare and vowed to repeal it once they took office. Yet, the voters did not choose them to lead the nation for the next four years. Instead, they chose the instigator of Obamacare himself.
Then, over the past 2 ½ years, House Republicans voted more than 40 times to kill Obamacare. The Senate ignored the House. The Republican Party faithful were pleased with the votes, but the law remained intact.
And it is not over. Now the House majority shut down the federal government to get at Obamacare. The House Republicans have voted repeatedly to continue funding the government only if implementation of Obamacare was delayed.
When that does not work, they will try to take the nation into default to stop Obamacare. Already, some Republicans are planning to couple paying the nation’s bills to the president agreeing to postpone Obamacare.
Yet, the law continues. Nor is it likely to fail anytime soon. Even if Republicans gain control of the Senate next year, President Obama will veto legislation intended to destroy his signature policy. The soonest Republicans could damage Obamacare would be 2017, and that is assuming the new president is a Republican.
By that point, most of the kinks in implementation will be worked out and Americans will have become accustomed to Obamacare. Parents will appreciate the fact that their young adult children, married or single, are eligible to remain on their parent’s insurance until they are 26. People with pre-existing conditions will be glad they don’t have to worry about being denied health care. Those who become seriously ill will be relieved to know that their insurance company can’t drop them now.
Poor families will want to keep the insurance they now receive thanks to the subsidies provided under the law. And they will be grateful that Medicaid eligibility was expanded to people with incomes up to 133 percent of the poverty line. Of course, that assumes their state goes along with that expansion. Most states have agreed to do so. Utah’s governor has yet to say what he will do.
And, as of yesterday, health exchanges became operational. They will provide more choice to consumers and will offer lower premium rates than Americans could get in the past.
Those who continue to see Obamacare as the genesis of government-sponsored health care (as if Medicare had nothing to do with the government) may never be convinced that this is not socialism.
However, most Americans will realize that Obamacare is far from a socialized system where the government pays the bill for everyone’s health care. Instead, what Obamacare really does is set regulations on the health care insurance industry that did not exist previously, offer more private competition for health care insurance coverage, require individuals and companies who avoid the private health care insurance system to join it (or pay a fee), and therefore expand access to private health insurance (and health care) to tens of millions of Americans who previously did not have it.
That doesn’t mean Obamacare is without flaws – both in design and implementation. But the solution to those flaws is not to kill or even delay the implementation of these reforms that are now, and yet will be, important in improving the lives of so many Americans currently without health insurance. Rather the solution is to reform it to correct those flaws. Obamacare is here to stay. So let’s work together to make it better.
Richard Davis is a professor of political science at Brigham Young University. His opinions do not necessarily reflect those of BYU.
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