Part Four - Enactment of the Affordable Care Act

Part Four of Why I Plan to Vote Democratic

This is the fourth in a series of blogs on my intent to vote not only for President Obama, but a straight Democratic ticket at the national, state, and local levels. I plan to look at issues that are important to me and I believe important to the American people.

I welcome your responses, whether you are a Democrat, Republican, or something else. I will publish whatever comments you have unless they are mean-spirited or do not speak directly to the issue addressed in this particular blog.

On March 23, 2010 President Obama signed the Patient Protection and Affordable Care Act into law; and on June 28, 2012 the U.S. Supreme Court upheld its constitutionality.

 Together with the Health Care and Education Reconciliation Act, it represents the most significant regulatory overhaul of the U.S. healthcare system since the passage of Medicare and Medicaid in 1965. PPACA is aimed primarily at decreasing the number of uninsured Americans and reducing the overall costs of health care. It provides a number of mechanisms—including mandates, subsidies, and tax credits—to employers and individuals in order to increase the coverage rate. Additional reforms are aimed at improving healthcare outcomes and streamlining the delivery of health care. PPACA requires insurance companies to cover all applicants and offer the same rates regardless of pre-existing conditions or gender The Congressional Budget Office projected that PPACA will lower both future deficits and Medicare spending.

In congressional debate on the bill, Republicans quickly dubbed it “Obamacare.” It was intended as an epithet that would be the millstone around the President’s neck and would sink his presidency in the 2012 election. That name gives far too much credit to President Obama. Despite the fact that all but one Republican in the Senate voted against the bill and all 178 Republican members of the House voted against it, and that immediately after it was passed Republicans introduced legislation to repeal the bill, the Act has Republican provisions throughout, as well as provisions by conservative Democrats and Independents.

From the moment it came out of committee, I was disappointed in the bill. I wanted a single payer provision, but that was too “extreme” for most congressional members. What was passed and upheld by the U.S. Supreme Court is far more complicated than it had to be and will require legislative work as we go along; but for me there was no question about this Act being a step forward in our history. I commend the President and the members of the House and Senate that persevered to make possible truly historic legislation.

Many Republicans may come to rue the “Obamacare” epithet because it gives so much credit to the President, and not at all the millstone they imagined it to be.

Nobel Prize winner in economics, Paul Krugman, said Sunday that this election is not the referendum on President Obama that Republicans thought it would be. He said,

Voters are, in effect, being asked to deliver a verdict on the legacy of the New Deal and the Great Society, on Social Security, Medicare and, yes, Obamacare, which represents an extension of that legacy. Will they vote for politicians who want to replace Medicare with Vouchercare, who denounce Social Security as “collectivist” (as Paul Ryan once did), who dismiss those who turn to social insurance programs as people unwilling to take responsibility for their lives?

I think Krugman has put his finger on the fundamental issue of this year’s national and state elections.

The enactment of “Obamacare” is change I believe in, and is one of the reasons I plan to vote Democratic. Where do you stand on this issue?

- Milo