Last week, the open enrollment period for Obamacare officially ended, and a major goal has been reached: about 7.1 million people signed up for insurance on the exchanges. This surpasses the CBO’s initial estimate of 7 million enrollments (which, I should note, was lowered to 6 million after the botched rollout of Healthcare.gov).
It’s important to stress that 7 million isn’t the total number of people who’ve gained health insurance thanks to Obamacare. It doesn’t include people who were eligible for expanded Medicare, or people who bought policies directly from insurance companies, or people who still have coverage because the ACA’s new regulations kept insurers from dropping them for getting sick. When all these groups are added up, the total number of people who’ve benefited from the ACA could be as high as 25 million (and would be even higher if Republican-controlled states hadn’t refused the expansion of
This isn’t the end of the story, just another milestone on a long path that’s already seen many of them. But it’s all the more noteworthy considering that this law has had to overcome probably the most tenacious resistance that’s ever confronted any major piece of American legislation.
Some of Obamacare’s wounds were self-inflicted, especially the disastrous rollout that kept the federal exchange unusable for almost two months, but far more came from unanimous, brick-wall opposition by conservatives. There was a blizzard of lawsuits that ended with a dramatic Supreme Court victory (although the contraception mandate is still being litigated); a GOP-led House that’s voted futilely to repeal or delay the law more than fifty times, and even shut down the federal government in a failed attempt to blackmail the Democrats into going along with them; and when all that failed, an advertising blitz by right-wing billionaires who’ve spent hundreds of millions of dollars trying to persuade people to forego health insurance. (Needless to say, the Koch brothers haven’t offered to pay the medical bills of anyone who skipped signing up on their advice and then came down with a catastrophic illness.)
But the ACA triumphed in spite of all these efforts: the law is doing what it was designed to do, and every indication is that it will work. The conservative response to this has consisted mainly of furious denial, like the pundits and even senators who insisted that the 7 million figure couldn’t possibly be real, that the Obama administration must be putting out fraudulent numbers.
The success of the law has put Republicans in a stark dilemma. They never had, and still don’t have, an alternative to offer. Their entire strategy was premised on hoping that Obamacare would either fail by itself, or that they’d be able to strangle it in the cradle before it took effect. But neither of those things happened, and now they’re faced with the reality that repealing it would take health care away from millions of people.
In fact, in the early days, prominent Republicans were so certain the law would fail that they were already gloating about the victory that was sure to come. There’s an obvious parallel to their utter confidence that Mitt Romney would win a landslide victory – and it appears they learned no lesson at all from that experience.
Obviously, Obamacare is far from a perfect solution. It’s a complex, kludgey, jury-rigged piece of legislation with a decidedly modest goal: to fill in the gaps of America’s healthcare system with as little disruption as possible. Even if it works exactly as intended, it won’t achieve the ideal of universal coverage in the U.S. But in a political environment so implacably hostile, dominated by conservatives who reject the very concept of government as a means of helping each other do what we can’t achieve alone, any step forward is a victory. And this isn’t a small step. There are millions of people who can afford to see a doctor now, some for the first time in their lives. For all those who care about human welfare and the common good, this is an achievement worth celebrating.
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