Come for the politics, stay for the snark.

Nothing worth doing is easy.

There are consequences to being an arrogant, sullen prick.

“Squeaker” McCarthy

Republicans in disarray!

Anyone who bans teaching American history has no right to shape America’s future.

It’s easy to sit in safety and prescribe what other people should be doing.

A snarling mass of vitriolic jackals

Come on, man.

They think we are photo bombing their nice little lives.

Happy indictment week to all who celebrate!

If you’re pissed about Biden’s speech, he was talking about you.

No offense, but this thread hasn’t been about you for quite a while.

… among the most cringeworthy communications in the history of the alphabet!

Bad news for Ron DeSantis is great news for America.

Republicans are the party of chaos and catastrophe.

He seems like a smart guy, but JFC, what a dick!

Seems like a complicated subject, have you tried yelling at it?

“What are Republicans afraid of?” Everything.

Speaking of republicans, is there a way for a political party to declare intellectual bankruptcy?

Our job is not to persuade republicans but to defeat them.

Second rate reporter says what?

We’ll be taking my thoughts and prayers to the ballot box.

They traffic in fear. it is their only currency. if we are fearful, they are winning.

Never entrust democracy to any process that requires republicans to act in good faith.

You are here: Home / Anderson On Health Insurance / We did it — the ACA survived

We did it — the ACA survived

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Over the past few days, my little corner of nerd and advocacy world has been having a long collective de-stressing breath that most of us had not realized we had been holding in for four years and three months.  The Affordable Care Act has survived.  In some ways, the individual market components of the ACA are now closer to the House Democrats vision in Spring 2009 than how it was operationalized by the Obama Administration in Winter 2017.  Silverloading has done weird things! That was not a likely outcome of a Republican trifecta.

I want to pull back something from May 2017:

In a previous thread, a troll was FIRST!! with the advice to “Just quit, we lost this fight in November”

I reject that.

We aren’t going to win often but we get to choose how to lose. We can roll over without trying to defend our values and our morals or we can fight as hard as we can to either get a policy win or inflict significant political costs on Republicans to increase the probability of future policy wins by either putting the fear of losing their seats into them which constrains future opportunity space or flipping those seats in 2018.

More subtly, we tell stories to ourselves. I want those stories that I tell to myself about me to be true. Defending and improving the ACA is one of those stories that I tell myself. The ACA benefits 2009 me far more than it benefits the 2017 me. It is a gut check. Am I full of shit or do I actually believe in what I think I believe in.

We did that.

We got policy wins.  We got political wins.

There is still need to moot a farcical suit that is currently at the Supreme Court.

But the ACA is likely to be around in 2022.  It is likely to get a highly needed update and corrections revisit by Congress.

That is not what I would have put any money on four years ago today.

 

 

Reader Interactions

72Comments

  6. 6.

    Nobody in particular

    What really chaps my hide is that the people who criticize it – in its current form – forget that it was the GOP that wouldn’t let it pass with a public option. There are many things about any political parties I detest but this is another case of the GOP making sure any Dem president’s legacy is sabotaged.

    If the people like it…

    Oh no, we can’t have that!

  7. 7.

    Almost Retired

    Add the survival of the ACA to the list of sighs of relief I am emitting today (I’m practically hyperventilating).

  12. 12.

    fake irishman

    As a fellow of the members of that Health Policy nerd and advocacy world,  I agree this has been a long strange trip, almost none of which I had on my bingo card four years ago.

  13. 13.

    StringOnAStick

    Four years ago my husband’s plan for us to retire 2 years early looked impossible because we feared the ACA was toast, and we couldn’t retire without it because of pre existing conditions.  Thanks to how hard people and politicians worked to save it, we are on an ACA plan and retired, living in a new state in a home we can age in place in and living our best lives in grateful happiness.

  15. 15.

    Another Scott

    I believe that you and Charles Gaba and all of your colleagues that kept us informed about the ACA and how to get the most out of it and how to protect it and make it better played a very large roll in it still being here today.  And your detailed, formal comments on ACA rule-making.

    You walked the talk.

    You are a gentleman, a citizen, and a scholar.

    Sincerely – Thank you for all you do.

    Cheers,
    Scott.

  21. 21.

    fake irishman

    @tim:  Yeah, if nothing else, it seems like the odds of this being slipped into a appropriations bill have gone up immensely.

  24. 24.

    Mary G

    Thanks to John McCain and his lovely thumb. I was sitting at my desk and started screaming so loud I scared my cats. Also thanks to the lame duck for pissing John McCain off. Also, too, the people who learned that having health care insurance is better than not and that no one had to have a death panel for Grandma. Such a big fucking deal.

  26. 26.

    Jim, Foolish Literalist

    Is Al Gore there? Cheney? I heard Quayle’ name mentioned

    Only six USSC Justices? Breyer, Thomas and Alito not in the line

  31. 31.

    Brachiator

    The Affordable Care Act has survived.

    Yep. Definitely something to celebrate.

    With respect to the Supreme Court, I see that Biden has chosen Elizabeth Prelogar to be acting Solicitor General. Well qualified. She worked for Mueller, clerked for Merrick Garland, RBG and Kagan. I think she has argued seven cases before the Court.

  38. 38.

    zhena gogolia

    Ella Emhoff looks so cute in a plaid coat with seemingly amber beads as epaulets.

    ETA: Sorry to be doing this, but there’s no Inauguration thread!

  39. 39.

    Matt McIrvin

    @David Anderson: A bill to fix all those little bugs in the ACA, and make the clown suit irrelevant, would be fantastic. Do you really think it’ll get through the Senate, if Manchin is unwilling to countenance killing the filibuster and the Republican minority still just want the ACA to fail?

  43. 43.

    David Anderson

    @Matt McIrvin: there is a lot of space that can be done with administrative rule making…. but yeah, I do anticipate a lot of things can be cleaned up via reconciliation or a Christmas tree end of the year appropriations bill with 29 words here, 44 words there, 3 pages here….

  44. 44.

    O. Felix Culpa

    So glad to see real America on the stage! Michelle looks like a queen. I love seeing the women wearing color and pearls.

  46. 46.

    lee

    My idea for a quick bipartisan bill is to raise the age to stay on your parents insurance to 30.

    Yeah it’s not M4A, but is one of the popular pieces of ObamaCare and it will help out a lot of the unemployed right now.

  57. 57.

    Matt McIrvin

    @David Anderson: Imagine… actual functional legislation to make things work better. I’m sure there will be another round of moaning about it not being Medicare for All. But it could ensure coverage for a lot of people.

    Just making the people who fell into the hole created by their state rejecting Medicaid expansion eligible for subsidized exchange plans… that would be a big improvement.

  60. 60.

    fake irishman

    “My leader and I entered on that hidden path to return to the bright world; and, without taking care for rest at all,

    up we climbed, he first and I second, until I saw the beautiful things the heavens carry, through a round opening.

    And thence we came forth to look again at the stars.”

    (Dante seemed appropriate for today. Also, there’s a huge mountain he and Virgil have  to climb over the next 33 cantos after these lines, which also seems right)

  61. 61.

    Repatriated

    When a dog rolls over, it’s surrendering. When a cat rolls over, it’s preparing for a fight to the death — and has just brought its hind claws into play…

  68. 68.

    Enhanced Voting Techniques

    The thing that stands out to me about that time was Adam stressing from the number of people he had to talk down from suicide.

  69. 69.

    Feathers

    @lee: I had a friend saying they wanted to be able to put their parents on their insurance.

    David – would that be a possible ask?

  70. 70.

    SectionH

    I know this is beyond late BUT this is a TY to David for all of the information. And my own Happy: I called my firend (that’s deliberate) to see how she’s surviving her breast cancer surgery. She answered the phone with “WE DID IT.” She lives in Tennessee btw. And yeah, she’s doing well. Hope everywhere.

  71. 71.

    PaulB

    Because the ACA survived, I was able to retire in December, giving my slot to someone younger and hungrier. Had Biden not been elected, had Democrats not retained the House, I’d have had to wait another few years until Medicare became available.

    Given my circumstances, there is simply no way for me to get private insurance without the ACA, much less have an opportunity to get something affordable.

  72. 72.

    There are those who call me...tim... (Still posh)

    @David Anderson: okay. Last I heard on this subject, Senator Franken had a fix simmering in committee. Yes, Franken. That’s how long.

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