Safe and Sound: Extreme Politics Will Save the ACA

Carlos barria reuters clinton supporters sad

When I look at pictures of Clinton supporters on election night 2016, it reminds me of the feeling that accompanied the loss — a sick, empty disbelief. In this picture, the unthinkable is unfolding for these people. I remember being shocked, wondering about a lot of things and at some point I wondered, “What is President Obama thinking?” Was he worrying for the country, or feeling bad for Hillary Clinton, or was he wondering what would become of his signature legislation, the Affordable Care Act?

Fortunately, we have David Remnick’s piece in the November 28, 2016 issue of the New Yorker.  Remnick had a number of conversations with President Obama after the election. While Obama said during the campaign that his accomplishments would be undone with a Trump victory, he was less apocalyptic to Remnick, reflecting that it was tough to move government very quickly, so the new administration was unlikely to be able to do too much.  However, Remnick writes, the President also predicted, “Obviously, the Affordable Care Act, I think, is most vulnerable, because that has been a unifying boogeyman for Republicans over the course of the last six years.”

Obama serious AP

Barack Obama and many other Americans were justifiably concerned about the prospect of the Republican-controlled government repealing the ACA. After years of Republican House attempts to repeal or hobble it and universal agreement among Republican candidates during the primary on repealing and/or replacing the law, it seemed a certainty.

Now, due to the ‘no’ votes of three Republicans and every Democrat, the repeal process has stagnated, and cooperation between the executive and legislative branches seems to be heading that same way. A full repeal or even comprehensive right-wing retooling seems unlikely at this point. Perhaps not surprisingly, Obama did predict that Republicans would run into their own voters if they tried to repeal the ACA. Remnick writes:

“He [Obama] said that, while the Republicans would have to make some attempt to deliver on that, they had to proceed with care, because the program’s twenty-odd million beneficiaries included many Trump voters, ‘even,’ said Obama, ‘if they don’t make the connection.’”

They did make the connection, and in addition, advocates of protecting the ACA turned out in droves to make their presence known.

Mccain McConnell

Repeal stall aside, the attacks on Obama’s legacy are ongoing. For one, Jeff Sessions has set to work rolling back Obama-reforms to mandatory minimum sentencing, Trump has signaled that he intends to pull the US out of the Paris Climate Accord and is in the process of eliminating Obama regulation concerning coal-powered power plants.

However many attacks are coming to Obama’s legacy, the current extreme political environment might actually be the key to the survival of Obamacare.

A June 2017 poll by The Kaiser Family Foundation showed that 64% of registered Democrats support single-payer healthcare. On the right, 28% of Republicans support it.  The poll found that 55% of independents tip the boat and create a national majority in favor of national single-payer healthcare. Single-payer is, of course, anathema to the values of the GOP.

Single Payer Now Flickr Michael Fleshman

We know conservatives do not like single-payer, and we know that liberals do, at least if we go by the poll numbers. In fact, Bernie Sanders is sending e-mails to his supporters, soliciting advice on how to craft his push for Medicare-for-all.

The situation is this: conservative voters seem to have eschewed the idea of a simple Band-Aid-rip approach to repealing the ACA, and they seem to be frustrated with the idea of leaving it alone. But they also do not want to see a serious push for single-payer. Given the choice between no healthcare law, and a single-payer regime, repairing and improving the ACA seems like the most obvious solution – not too hot, not too cold, the Goldilocks zone.  A Gallup poll from April 2017 found that 55% of respondents supported the ACA, and one from May found that 58% viewed a federally funded healthcare system favorably. Effectively, the two extremes presented by the loudest Democratic and Republican voices are making the status quo seem a lot more comfortable, and people are finding that they like in general the ACA when it is effective. They don’t want a repeal, they don’t want government doctors, they just want improvements.

ACA supporters march Scott Olson:Getty Images

David Remnick, recounting Obama’s words in the New Yorker writes, “If the Republicans ‘tinker and modify but still maintain a commitment to provide health insurance for the people who received it,’ he said, ‘then a whole bunch of stuff hasn’t gone out the window.’”

Whether by lack of action or sincere effort to build a bipartisan healthcare law, the ACA looks poised to have a bright future as the landmark law that extended coverage and established the principle that Presidents since Truman have tried to establish – that legitimate healthcare should be accessible for all Americans. I don’t think that Obama or any of those shocked Hillary supporters on election night 2016 thought that would be the case, or that the heavily polarized political climate we find ourselves in would be the reason.

Obama smileback


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