Seven Million and Counting

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

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 Medicare Medicaid).

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.

Image credit: Shutterstock

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About Adam Lee

Adam Lee is an atheist writer and speaker living in New York City. His new novel, City of Light, is available in paperback and e-book. Read his full bio, or follow him on Twitter.

  • Loren Petrich

    The Republicans have claimed that they want “Patient-Centered Health Care”. This phrase was coined by Republican pollster Frank Luntz, and featured by him in a memo called “The Language of Health Care”.

    But the Republicans’ lack of an alternative has shown that this phrase is a hollow one.

  • Gideon

    Just one of the many ironies is that conservative support for the old status quo is nowhere close to supporting a “free” market either. They know very well that if they had hypothetically tried to implement their stated principles, i.e. push the old status quo toward lesser government involvement and funding, they would have faced the same level of town-hall anger as Obamacare (I wonder how many years that name will stick?).

    And how long ago was it that Obamacare-like subsidies for paying insurance premiums were considered the conservative approach to health care reform?

  • DavidMHart

    Surely you mean ‘jerry-rigged’ in the last paragraph? Tampering with juries is probably not a realistic consequence of the ACA :-)

    [Edit - okay; I take that back; I had a look around, and it turns out 'jury-rigged' is a valid alternative pronunciation that I hadn't heard of ... although it still sounds too tampering-wth-the-legal-system-ish for me to not find it odd...]

  • GCT

    According to this link I found, it’s not so much a “valid alternative pronunciation” as it is 2 distinct expressions.

    Following this guide, “jury-rigged” would still fit the bill better than “jerry-built.”

  • Nathaniel

    But but Benghazi! Death Panels! Obamacare was an inside job! Where’s the ACORN? What did Joe Biden know about Paul Ryan and when did he know it!!!!!

  • Annerdr

    “Republican-controlled states hadn’t refused the expansion of Medicare”
    It’s Medicaid, not Medicare, that they wouldn’t expand. Because Jesus didn’t want the poors to have health coverage.

  • Tracy Burgess

    Paul Ryan has been trying to push a fictional budget for several years now. I say fictional, as he does not use real numbers or real accounting techniques. His driving desire is to end Social Security, Medicaid, Medicare, and move to private pensions and charities.

    Clearly Mr Ryan has no clue that many folks have no work pensions or they lost them in the recession. Charities are generally poorly run and not set up for handing out cash. But worst of all, making the ill, disabled, elderly & poor go door to door begging.for help is monstrous. If anything has been proven in the recent anti-gay discrimination bills, it is that it proves that we can not count on these ideas of charity to assure our citizens have access to healthcare, food, safe pensions. If these fundamentalists can discriminate about baking a cake surely they would deny any support of “undesirables”.

  • J-D

    If you ask the charities themselves, they don’t say ‘Sure, we can take over instead of government programs’, they say that what they do complements and supplements government programs but can’t replace them and that the continuation of government programs is essential.

  • Loren Petrich

    As recently as early in Obama’s Presidency, when Mitt Romney recommended Romneycare as promoting individual responsibility and the free market, something he did in a US News op-ed: 07/30/09 – Mr. President, What’s the Rush? | Mitt Romney Central. But when Obama and the Democratic Congresscritters actually enacted it as Obamacare, he followed the Republican party line and attacked it.

    He enacted it in Massachusetts in 2006 when he was governor there. Back in 1993, John Chafee (R-RI) proposed it as an alternative to Clinton care, and in 1989, it was proposed by the Heritage Foundation (History of the Individual Health Insurance Mandate, 1989-2010 – Obamacare / Health Care Laws –

    The right wing was not very enthusiastic about Heritagecare, Chafeecare, or Romneycare, but the right wing did not oppose it very strongly. Certainly nothing like their screaming bloody murder about Obamacare.

  • 8DX

    From the Hannity radio show in the link: “The young and healthy, pay for the poor, the sick and the uninsured” Yes! That’s how it’s supposed to work (Sheesh, also pay for the old, the handicapped, the underprivileged)! It’s called the social contract and it’s one of the reasons we have government and taxation.

  • Science Avenger

    You forgot IRS! Fast and Furious! Soros! Alinsky! Ayers!

    That’s the great thing about fictional problems, there is an unlimited supply of them,

  • Science Avenger

    Paul Ryan has been the biggest disappointment. He’s supposedly the deep thinker policy wonk, but every time he gets asked a detailed question he either tres to drown it in jargon like “baselines” or flat says it’s too complicated to explain. He’s a fake, plain and simple.

  • Science Avenger

    It’s called “insurance”, something many in the GOP seem not to understand. I’m waiting any day now for them to attack homeowners insurance on the basis that we expect those who’s houses didn’t burn down to pay for those who’s houses did.

  • Korey Peters

    “we expect those who’s houses didn’t burn down to pay for those who’s houses did.”

    You monster!!

  • Adam Lee

    I’ve always seen it written as “jury-rigged”. I think this may be an Americanism.

  • Adam Lee

    Yeah, the Republicans’ ideological stance pretty much commits them to being against all forms of insurance, not just health insurance. I don’t think they’ve quite realized that yet, although I’m sure the day is coming – probably right around the time the cost of flood and fire insurance for victims of climate change starts to seriously eat into the economy.

  • Adam Lee

    As Paul Krugman and other pundits have said, one of Ryan’s most frequent and shameless tricks is the “magic asterisk“, in which he basically just asserts that his budget will cut spending or decrease the deficit by X dollars without providing any details of how this will be accomplished. But he’s a Serious Conservative Thinker!

  • Adam Lee

    Yep, thanks for the correction. I’ll fix the post.

  • Izkata

    “jury-rigged” seems to be the original. Some history has been dug up here:

  • DavidMHart

    Fair enough then. I will now stop tampering with your legal system :-)

  • 8DX

    The insured paying for the uninsured is not “insurance”, sorry. The principle that those who can’t afford healthcare (either through purchasing insurance or other means) are provided with it free of charge by the rest of society through taxation and the state, is about the social contract – and the principle that we have shared responsibility for each other in society.

    Insurance is just one method of redistributing variable-risk, variable-cost payments over a population and can exist perfectly well even in highly unequal societies.