Progressive Liberals—It’s Time to Stop Defending the Affordable Care Act

And start advocating for what we’ve wanted from the beginning—Single-Payer


In 2009, I started a small group called Fight for Healthcare (now defunct). The purpose of this group was to advocate for what I and many others believed was candidate Obama’s promise to enact a public health care option. As far as we were concerned, the public option, which was popular among three quarters of the population, was as close as the United States was going to get to a universal single-payer health care plan. It was no surprise that single-payer was off the table from the start of the health care debate, but the public option could have been, and should have been the crucial first step toward that end.

As the health care debate wore on, Fight for Healthcare and numerous other groups, organizations and movements ended up on the losing end, despite significant popular support. The public option passed the House, but died under the one-two punch of Ted Kennedy’s deaht and the droop-face opposition of Joseph Lieberman. Lacking movement leadership from the President was no small handicap either. At that point, advocates for the public option had to choose between walking away from the debate entirely or licking our wounds, accepting the political stage of the time and fighting for what was left.

Many of us dedicated ourselves to health care reform for the long haul. We got behind President Obama and the Democrats to defend what became known as Obamacare. We weren’t deluded. We recognized Obamacare for what it was, a colossal letdown representing the collapse of liberal hopes for comprehensive health care reform. At best, it was a sorry half measure that offered some improvements over a hopelessly flawed system, but lost any pretense of reform with the fall of the public option. At worst, it was a betrayal of the liberal Democratic base on the promise of real reform at a time when such reform simply should have happened but for the inexperience of the President and internal subterfuge from more conservative elements of the Democratic Party.

Regardless, folks like me expended considerable energy defending Obamacare. We did so because, as weak as it was, the Affordable Care Act was the only song and dance in town. From the practical, liberal perspective, the Affordable Care Act was a bitter disappointment, but still the only hope to improve the lives of millions of people. It did contain some concessions to the liberal base, such as the end of pre-existing condition exclusions. Indeed, this lackluster piece of legislation was broad enough in scope that, despite its shortfalls, it really did represent an improvement for millions of people.

Many of us also found ourselves defending Obamacare from the legally questionable and politically reprehensible attacks against the bill. Conservative opposition to the law was perfectly understandable. Despite the ACA’s conservative roots, having been formulated by the Heritage Foundation and advanced by the Republican Party in the early nineties, and as the key legislative accomplishment of Massachusetts governor Mitt Romney, the Affordable Care Act had to be opposed by Republicans because…well…because President Obama supported it. Contemporary Republicans are just viscerally incapable of supporting anything in conjunction with this Democratic President and are willing to do anything…anything…to subvert him. Such was the political strategy. Opposition, even senseless opposition, is one thing, but the nature of conservative obstruction was quite another. An honest debate could have advanced the political goals of providing affordable universal health care and preserving free market principles in the medical field. An honest debate, however, was not what we had. Instead, health care advocates found themselves fending off a relentless attack of right wing wraiths spreading balderdash about the nature of the bill, most notoriously represented by the so-called “death panels” nonsense that became an integral part of the debate. The flagrant dishonesty of the opposition became the focus of liberal defense right up to the final passage of the law.

Then the political maneuvering took on a different aspect. Conservatives were at their most innovative in finding ways to forestall, underfund, undercut and eviscerate the Affordable Care Act, even denying funds to help get the Federal exchange running. Texas governor Rick Perry threatened to secede from the Union, because that worked so well the last time. Red states refused to participate in creating exchanges. With a nod from the Supreme Court, these same states often refused to expand Medicaid, thus creating a health care lapse for those whose incomes are not high enough to participate in the exchanges, but not low enough to qualify for Medicaid. The ultimate tactic, however, was the political hostage taking in the form of Debt Ceiling Blackmail. Conservatives even shut down the government for weeks in a last breath attempt to overturn Obamacare.

Through it all, we were there, writing letters, making phone calls, supporting legislators, trying to inform the public. We, as liberals, fought as hard as we could for a piece of legislation that we never really liked. With the expense of such energy, many of us became invested in the Affordable Care Act in spite of ourselves. Our hearts sank when the Obama Administration flubbed the roll out. Many of us continued to advocate for the ACA, pointing out that a computer glitch should not be a condemnation of the law itself.

In this last matter, I was silent, however. Part of this was just fatigue. After so much time and energy put into defending what, to me, was a letdown, the least the Administration could have done was ensure a successful rollout!

More importantly, however, I knew that as of October 1st, the Affordable Care Act would rise or fall based on its own merits. I am tech savvy enough to know that computer glitches are short term problems. Once effective programming was written, everything else would fall into place. Indeed, it appears that that is happening. Opposition to Obamacare is now nothing more than political rhetoric. The Affordable Care Act is here to stay. By the time conservative Republicans are in a position to overturn Obamacare, too many people will rely on it, and will see that it is not the Obamageddon that it was made out to be. For what it’s worth, health care advocates have their victory.

But it’s not the victory that we wanted. As many advocates point out, the problems associated with Obamacare and the convoluted, Rube Goldberg nature of the legislation, would not be an issue had we simply switched to a single payer system. Had we just eliminated the sixty-five and over requirement for Medicare coverage, we would have a universal health care system under a popular single-payer. Yes, taxes would go up. The increase in taxes, as revealed by health care systems throughout the world, however, would have been more than compensated by the elimination of premiums and co-insurance payments that continue to plague us. So long as a mostly private system of health care access exists in a nation with an aging population, health care costs will continue to increase, albeit slower under Obamacare. Despite the Affordable Care Act, the United States remains in desperate need of health care reform. A single-payer system would put us in line with the rest of the world.

Now that Obamacare is established, it is time for liberals to stop defending it. If Obamacare is going to fail, let’s let it fail and gird ourselves for the next fight by educating people on the benefits of a single payer system. If Obamacare is, for the most part, going to work, which appears to be the case, let’s continue to educate the public about single-payer systems because such reform is the next logical step in this evolution.

This debate is not lost with the rise of Obamacare. It is only beginning. Now that the rhetorical sparring has stopped and the resulting anger and fear has subsided, a rational discussion can be had. I was just involved in a conversation with a man who was angry with liberals for forcing the Affordable Care Act “down my throat.” When I explained to him what liberals really wanted, a single-payer system, and explained it in terms of expanding Medicare, he crossed his arms and looked at me quizzically and said, “Well, why didn’t we do that, then? That makes a hell of a lot more sense than Obamacare.” He was right. That’s the reform we should have had, but this sensible message got lost in the rhetorical fight over the Affordable Care Act and associations with creeping socialism. Now that the craziness is done, maybe we can have a real debate.

It’s time to move on from Obamacare!

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