President Biden and top Democrats have spent weeks mounting a full-scale blitz to tout the Affordable Care Act, including ads, social media posts, speeches \u2014 and a video that blasts rival Donald Trump for \u201crunning to \u2018terminate\u2019 the ACA.\u201d<\/p>\n
Trump \u2014 who as president pushed to kill the law and last November reiterated that he wants to \u201creplace\u201d it \u2014 has angrily countered on social media that Biden \u201cDISINFORMATES AND MISINFORMATES ALL THE TIME,\u201d and that all Trump wants to do is make the 14-year-old law better.<\/p>\n
Biden\u2019s celebration and Trump\u2019s grudging acceptance of the ACA underline a striking reality: a law once derided as \u201cObamacare\u201d and demonized as a big government power grab is becoming a politically untouchable part of the American safety net, like Social Security and Medicare before it.<\/p>\n
More than 45 million people now rely on the ACA and its provisions for health coverage, according to a federal report released last week, and the law\u2019s protections for people who have preexisting conditions have transformed many Americans\u2019 experience of health care. Yet for nearly a decade, Republicans like Trump successfully ran on pledges to \u201crepeal Obamacare\u201d \u2014 and Democrats sometimes ran from it, scarred by the law\u2019s bumpy rollout, the constant political attacks and the struggle to communicate its benefits.<\/p>\n
Just 33 percent of Americans held favorable views of the ACA in November 2013, weeks after the infamous crash of the Healthcare.gov website intended to let Americans sign up for private health insurance through the law, according to KFF, a nonpartisan health research organization.<\/p>\n
But when Trump and his Republican allies nearly repealed the ACA \u2014 falling one senator short in July 2017 \u2014 it sparked passionate efforts to defend it and catalyzed new, long-lasting support. Today, 59 percent of Americans hold favorable views of the law, according to KFF.<\/p>\n
\u201cThere was a campaign, starting in 2010, that was all about the negative things that ACA did to you. There was never a campaign about what it brought to you,\u201d said Mollyann Brodie, a KFF executive vice president who oversees its polling operation. Following the near-repeal, she added, \u201cthe Democrats were able to switch it on its head, and use the scare tactic \u2014 \u2018They\u2019re going to take away these popular things you care about.\u2019 They flipped the narrative.\u201d<\/p>\n
If voters initially responded to GOP alarms that the ACA was \u201csocialized medicine,\u201d many are now more swayed by its popular provisions, like one that lets young people stay on their parents\u2019 insurance policies through age 26.<\/p>\n
That evolution reflects a political reality: while voters often resist sweeping government changes in theory, they tend to become attached to individual programs and concrete benefits. The ACA\u2019s current popularity seems to bear out former House Speaker Nancy Pelosi\u2019s oft-mocked 2010 insistence that once Americans found out what was in the law, they\u2019d want to keep it.<\/p>\n
\u201cI\u2019m not surprised that people find the access to more affordable insurance to be a good thing,\u201d said Nancy-Ann DeParle, who served as Obama\u2019s top deputy on health reform, helping shape the law and steer it through Congress. \u201cIt\u2019s part of the fabric of our health care infrastructure and safety net now.\u201d<\/p>\n
Most Republicans are now wary of mounting another repeal effort, preferring to shift the conversation to friendlier terrain such as the economy and immigration. Even its critics talk about improving it, not destroying it, a tacit recognition that Obamacare is probably here for the long term.<\/p>\n
\u201cThe ACA continues to be deeply flawed and need radical reform,\u201d said Joe Grogan, who led the White House Domestic Policy Council under Trump.<\/p>\n
Democrats, meanwhile, are eager to talk about the ACA on the stump at every opportunity.<\/p>\n
\u201cWhen you\u2019ve got great news to talk about, why would you not?\u201d Health and Human Services Secretary Xavier Becerra said in an interview. The nation\u2019s top health official added that he brings up the ACA \u201cpretty much everywhere I go.\u201d<\/p>\n
\u201cEveryone knows Social Security, Medicare and Medicaid \u2014 but now you\u2019ve got the cleanup hitter, the ACA marketplace,\u201d Becerra added. \u201cThose four programs keep Americans not just from dropping into the poverty pool, but also keep them alive.\u201d<\/p>\n
The ACA\u2019s current popularity sometimes surprises lawmakers scarred by the struggle to enact the law across 2009 and 2010 and the powerful backlash that followed.<\/p>\n
That 14-month battle led to Democratic infighting and sparked false accusations, such as former Alaska Gov. Sarah Palin\u2019s claim that the law contained \u201cdeath panels\u201d to ration end-of-life care. Former president Barack Obama\u2019s approval rating plunged from 66 percent in January 2009, when he entered the White House, to 49 percent in March 2010, the month he signed the ACA into law, according to Gallup\u2019s tracking poll.<\/p>\n
Many voters believed that enacting Obamacare would harm their own health coverage. Becerra, a congressman at the time, recalled walking to the House\u2019s final ACA vote and being met by protesters urging lawmakers to \u201ckeep your stinking government hands off of our Medicare\u201d\u2014 apparently unaware that Medicare, too, is a government-run program.<\/p>\n
Less than eight months later, Republicans picked up 63 seats in the House, defeating dozens of Democrats who had voted for the ACA. Political scientist Brendan Nyhan and his colleagues later estimated that the health law cost 25 House Democrats their seats, enough to swing the chamber to GOP control in 2010.<\/p>\n
\u201cIt was a potent political weapon,\u201d DeParle said. While some provisions immediately took effect, such as allowing young adults to stay on their parents\u2019 health plans until age 26, \u201cpeople hadn\u2019t yet seen the benefits of the law \u2026 and we were continuing to face a barrage of negative ads.\u201d<\/p>\n
By his 2012 State of the Union address, Obama was nearly skipping over the ACA in public, devoting just 44 words \u2014 0.6 percent of his speech \u2014 to health care and a law that he now calls his proudest achievement. More problems lay ahead, including the failed October 2013 rollout of the ACA exchanges as the website crashed after launch.<\/p>\n
\u201cIt was so politicized,\u201d said KFF\u2019s Brodie. \u201cThe ACA became kind of a proxy for how you felt about President Obama and the administration.\u201d<\/p>\n
When Trump won the presidency in 2016, Republicans controlled the White House and Congress for the first time since the ACA\u2019s passage, and they began openly speculating about how quickly they could overturn the law. Conservative policy experts Brian Blase and Paul Winfree, who went on to serve in the Trump White House, published a repeal road map.<\/p>\n
Obama staffers who had worked for years to implement the ACA wept in their offices, some recalled in recent interviews, believing the law\u2019s time was up. HHS Secretary Sylvia Mathews Burwell invited the agency\u2019s political appointees to a meeting the morning after Election Day, seeking to reassure them that Republicans\u2019 repeal effort would face serious roadblocks.<\/p>\n
\u201cPart of it was understanding, \u2018This is not over, team,\u2019\u201d Burwell said in an interview, recounting her efforts publicly for the first time. \u201cWe\u2019ve got the substance on our side. Now we\u2019ve got to do what it takes.\u201d<\/p>\n
Burwell and her team rolled out a 70-day crash plan to shore up support for the health law, developing targeted maps to show members of Congress how the law was affecting their communities. She worked the phones to reach GOP lawmakers and governors, seeking promises that they would not cut the protections for people with preexisting conditions \u2014 one of the most beloved parts of the law, and one of the most integral. Burwell knew preserving that provision would complicate the ability to repeal the broader ACA.<\/p>\n
Republicans, meanwhile, found that campaigning on repeal was easier than delivering it. House Speaker Paul D. Ryan (R-Wis.) was confronted by Republican voters who said that the ACA had saved their lives \u2014 and by GOP lawmakers angry that Ryan\u2019s repeal plan didn\u2019t go far enough. Ultimately, Sen. John McCain (R-Ariz.) blocked the repeal in a dramatic late-night vote, a move that earned him Trump\u2019s unending fury.<\/p>\n
McCain, who died of brain cancer the following year, was joined in his opposition by two other Republican senators, Lisa Murkowski of Alaska and Susan Collins of Maine, and both continue to defend their votes.<\/p>\n
Democrats ran on the GOP repeal efforts, helping them recapture the House in 2018. A new generation of Democratic politicians \u2014 including Washington state doctor Kim Schrier and Illinois nurse Lauren Underwood \u2014 crafted successful campaigns around their personal health care experiences.<\/p>\n
Blase, the former Trump White House official, who now leads the conservative-leaning Paragon Health Institute, framed the turnaround in the ACA\u2019s fortunes as part of a natural political cycle.<\/p>\n
\u201cThe Democrats overreached in 2010, and you had a reaction,\u201d Blase said in an interview this week. \u201cAnd then the public thought that Republicans overreached on what they were trying to do in 2017, so you had a reaction the other way.\u201d<\/p>\n
Today, more Americans than ever have health coverage, with about 21 million insured through the ACA\u2019s private health plans, up from 12 million when Biden took office, according to a federal report released last week. Another 23 million gained coverage through the law\u2019s expansion of the Medicaid program.<\/p>\n
The Biden campaign has repeatedly touted the achievement, including in a video released last week in which Obama, Biden and Pelosi marked the law\u2019s anniversary. \u201cNow we have a chance to do even more, but that only happens if we send Joe and Kamala [Harris] back to the White House in November,\u201d Obama urges voters in the video.<\/p>\n
The White House regularly invokes the law in its public statements, pointing to Biden\u2019s expansion of subsidies for ACA shoppers and investment in staff to help shoppers find health plans. More ACA-related initiatives are coming this year.<\/p>\n
\u201cWe have plans to talk about health care regularly,\u201d said Neera Tanden, who leads the White House Domestic Policy Council.<\/p>\n
Some Republicans continue to target the law on Capitol Hill, including in a recent budget proposal that seeks to cut spending on the ACA and other federal health programs. Other conservatives are gritting their teeth and offering more limited critiques of a law they say they still passionately oppose.<\/p>\n
Blase, for example, criticizes the ACA\u2019s heavily subsidized health insurance plans, calling it \u201ca very efficient mechanism for the Treasury to transfer money to health insurance companies.\u201d The law\u2019s marketplaces, he added, have become a \u201cwelfare program.\u201d<\/p>\n
But the GOP has abandoned the coordinated \u201crepeal Obamacare\u201d campaigns that helped them win elections for nearly a decade.<\/p>\n
And Democrats, with an eye on the upcoming election, have added the ACA to the list of benefits they claim Republicans want to curtail, along with such items as abortion access and Social Security.<\/p>\n
But ending the ACA increasingly seems politically untenable. \u201cThe only way they\u2019re going to repeal it is politically getting it through Congress, and I just don\u2019t think the votes will be there,\u201d Becerra said. \u201cYou\u2019re going to have a whole bunch of very unhappy people protesting, saying, \u2018Keep your stinking hands off of our Marketplace coverage.\u2019\u201d<\/p>\n
Kevin Uhrmacher contributed to this report.<\/p>\n<\/p>\n
President Biden and top Democrats have spent weeks mounting a full-scale blitz to tout the Affordable Care Act, including ads, social media posts, speeches \u2014 and a video that blasts rival Donald Trump for \u201crunning to \u2018terminate\u2019 the ACA.\u201d Trump \u2014 who as president pushed to kill the law and last November reiterated that he […]<\/p>\n","protected":false},"author":0,"featured_media":2608,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-2607","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/posts\/2607","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/comments?post=2607"}],"version-history":[{"count":0,"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/posts\/2607\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/media\/2608"}],"wp:attachment":[{"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/media?parent=2607"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/categories?post=2607"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/tags?post=2607"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}