On this day in 2010, @BarackObama signed into law the Patient Protection & Affordable Care Act: a shining achievement that presidents had strived toward for more than a century.
Today, and every day, Democrats are working to ensure that health care is a right – not a privilege. pic.twitter.com/vBbA3dRIZc
— Nancy Pelosi (@SpeakerPelosi) March 23, 2023
In 2018, I was grabbing a beer with a friend, colleague and co-author. We were shooting the shit and wondering when our ACA line of research would become boring — useful but boring work that is part of the general background. We went through a few scenarios and figured 2025 was the earliest, 2028 was the most likely point where our research agenda would transition to the “mating habits of Northwest salmon” level of general public interest. This is good knowledge. It informs policy and has billion dollar impact but it is background information. I still think 2028 sounds reasonable.
But today, let’s celebrate a BFD.
I still have my BFD shirt. Thanks, Joe, for calling it what it is.
A BFD that has garnered 3rd rail protection in a surprisingly short period of time.
Almost certainly saved MY life, so I’ll raise a toast.
This is what gives me hope that eventually, COVID boosters will be normalized. The Eye of Sauron moves on to something else as its object of fascination.
CLAP CLAP CLAP CLAP
Shouldn’t the mating habits of Northwest salmon be a topic reserved for Balloon-Juice After Dark?
Such as putting children back to work (as long as they aren’t transgendered or gay).
@Matt McIrvin: That will only happen if or when not getting the vaccine is no longer a badge of honor, proof of membership in the “superior” tribe.
Anonymous At Work
Whenever have the mating habits of Pacific wild-caught salmon ever been mundane?
Add in the COVID disruptions and you have a few more years of research, especially if California and/or Intermountain in Utah succeeds in starting up generic drug manufacturing. I can imagine a researcher wanting to know if such an event is correlated with an uptick in cirrhosis and early deaths among insurance executives.
@bbleh: I am with you on that. ACA probably saved my life when I knew that I could indeed seek medical care without bankrupting the household. I had been ignoring warning signs for years because there was no point in looking for treatment I couldn’t afford.
I think Oregon Public Broadcasting has already run a series on the mating habits of Northwest salmon.
I’m here for that hot salmon-on-salmon action.
ETA: I wonder how green balloons work underwater.
@Anonymous At Work: those are good questions that I’m not particularly interested in chasing down.
I may be mis-remembering, but doesn’t salmon mating resemble the ACA politically as well? That is, about 70%-80% of the human population in the Pacific Northwest prefer the salmon and would like to get rid of some of the dams that block the fish, but the Republicans are locked into a pro-dam stance by Cleek’s Law?
Probably mostly right – but the PNW also gets a lot, maybe most, of its electricity from hydroelectric.
I think the next dam most people want to have removed is on the Snake River, which is currently the center of controversy precisely because of the salmon run/hydro electricity conflict.
@BellyCat: Nah, it’s my morning kink.
Unexpected good side-effect of the right-wing knee-jerk astroturned fight against the ACA — the recent WY Supreme Court decision to review the abortion ban in the state (and allow abortions to continue in meantime) was based upon an anti-ACA Amendment to the State’s constitution.
Talk shit, hit yourself.
New Deal democrat
Still a BFD, but a word of caution nevertheless: The ACA survived Supreme Court scrutiny by a 5-4 margin only after Roberts changed his vote. With Ginsburg replaced by Barrett, there are probably now 5 votes to throw it out.
What’s that, you say? It’s settled precedent now???
@New Deal democrat:
Point taken. Wonder if there’s anything out there working its way to the
And a big thank you to Obama, Pelosi and those who put their careers on the line to pass it. As a small business owner (coincidence, I went out on my own 13 yrs ago, too) this is the only way I could afford health insurance.
Obamacare allowed me to weather a period of prolonged unemployment and still have health insurance.
@New Deal democrat:
I believe the ACA is too embedded in the economy to be overturned. The disruption to insurers as well as medical providers would be enormous.
Very interesting! From your link, here’s the text of Article I, Section 38 of the Wyoming Constitution:
Denying abortion access would certainly strike me as the sort of “undue governmental infringement” that the state of Wyoming is required to preserve the rights in (a) and (b) from.
ETA: It would also seem to give Wyoming parents the right to authorize gender-affirming care for transitioning children of theirs, and physicians to provide such care, without fear of repercussion.
Thanks Obama! If not for the ACA, we’d be paying north of 26 large yearly to stay on my former employer’s plan. And with the IRA subsidies, monthly premiums were $200. Spouse just graduated to Medicare, so the subsidy adjusted to $400 for me alone. It’s still a huge bargain and peace of mind until I age up to Medicare. Thanks Obama and Biden/Harris!
@New Deal democrat:
But two big challenges since have been turned back even in a much more conservative court. Still plenty of bears in the woods, but it has proven surprisingly resilient.
Probably a few having to deal with mandatory provision of some services that are currently in Reed O’Conner’s courtroom in Texas. Results could be bad, but not a death sentence to the ACA; also there are ways around adverse results that Dave pointed out a few weeks ago here.
@MisterDancer: Ohio has one of these too.
I wish that were the case. But as we can see from the GOP games with the debt limit from 2011 to the present, there are many in their caucus who would cheerfully blow up our economy to own us libs.
And we have the example of Britain, which you’d think would have been too economically embedded with Europe to do something as crazy as Brexit. But they did, and it’s been an economic disaster.
Our right wing thinks that if we have economic collapse or civil war or whatever, they’ll get to rule over the ruins, and that’s all that matters to them.
@CaseyL: The 4 lower Snake River dams produce 933 megawatts out of the 14,400 megawatts Colombia Basin dams produce. They are primarily navigation dams, a bit of flood control. The barge traffic could be shifted to rail. The power is most valuable as easily dispatched peaking power which is kinda handy as more wind and solar comes on line. In comparison Hells Canyon dam, upstream of the 4 lower Snake dams produces 1167 megawatts. There’s very little talk of taking it out. The biggest PNW dam, Grand Coulee on the main Columbia produces a massive 6609 megawatts. The 8 dams in the Willamette River basin produce less than 400 megawatts.
Currently in Seattle. Salmon research, of any kind, is welcome.
The ACA allowed me to retire three years earlier than I otherwise would have been able to. Even better, the expansion of the subsidies has saved me thousands of dollars. For me, personally, it has indeed been a BFD.
@lowtechcyclist: This is pretty modern language for the Wyoming constitution. Were people saying “health care” in the 1880s?
@Jesse: That amendment was added in 2012.
I did some salmon research recently by making a paste of mustard and honey and using it to stick chopped pecans, breadcrumbs, and parmesan to the salmon before roasting in a hot oven
results indicated that increasing salmon populations is a good thing
so pull those dams down, for science
The ACA has not directly benefit anyone in my little family and yet, because I am a decent person (I don’t think that is too outrageous a self-compliment), I was thrilled to see it signed into law and continue to celebrate its existence. When I think of the reasons I am proud to be a Democrat, the ACA is high on the list.
In other news, I just went to open the garage door and discovered that the spring had sprung and I (all of us) are stuck in the house. Such is the price paid for our suburban car-centric lifestyle. The repairman is due in a few hours so maybe by supper time we’ll be able to get the cars out of the garage.
@Jesse: There is an effort by Alaska Representative Mary Peltola and Congressional allies to amend the Magnusen Act so as to tilt the balance in Northwest fisheries management away from the commercial trawler interests and towards smaller inshore fishing outfits as well as Native and subsistence fisherman. That could have a positive effect on populations of salmon and other fish in the Pacific Northwest.
Big Trawl is a powerful industry, and Peltola and company face a tough battle. She seems a very persuasive woman though, and is very knowledgeable in this area. Rep. Peltola and her allies may well push this measure through the next Congress.
New Deal democrat
@azlib: “I believe the ACA is too embedded in the economy to be overturned. The disruption to insurers as well as medical providers would be enormous.”
For comparison: “I believe *that abortion and reproductive health care are* too embedded in the economy to be overturned. The disruption to insurers as well as medical providers would be enormous.”
ETA: Not criticizing; just calling it out for your consideration.
@New Deal democrat:
The abortion stuff is horrible, but it’s effect on the overall economy is negligible.
@Baud: That’s actually something I wish David and colleagues would investigate. There are lots of possible downstream economic implications to this. What happens when nurses and doctors get fed up and leave the restrictive states? Some will, though others wil do the boiling frog thing. Lots more special needs babies coming who will require millions of dollars of support that has to come from someplace. Which is not a bad thing except when their parents do not actually want to continue those pregnancies and give birth/parent. And then those folks get pulled out of the labor market. Brain drain in red states as young people move to where reproductive rights are secure and pregnancy is safer. Nowhere near the impact of the ACA, but not negligible, maybe.
“IT”S (still) ALIVE”
New Deal democrat
@Baud: My point is that widespread horrible consequences have not been the slightest deterrent to this Court so far (see, also, gun violence).
@New Deal democrat:
Yeah, but this Court cares about corporations and the economy. If it were just people dying, the ACA would be as good as gone.
No guarantees, but I don’t think it’s an analogous situation.
Hell, there’s far too little support already for those parents who ‘win’ the lottery of finding themselves with a special needs child. We really need to do some serious work as a society to reduce the load that those parents face.
It’s a BFD. Those who are against justice and progress are eventually defeated.
you know it’s becoming normalized because no one is calling it Obamacare anymore.
I was on my parents platinum coverage for 3-years so a personal win.
@New Deal democrat: So far this Court has struck down only one gun law. That was a New York state measure regarding concealed carry permits, and the reason given was the discretionary aspect of the permitting regime. There are other, broader challenges working their way through federal courts, so we will see how hostile this Court is to gun safety legislation. Right now I think it’s an open question.
And Heller. That was striking down a gun law.
@Baud: Yes, Heller. I thought that Scalia’s opinion in Heller was actually favorable to gun regulation in general. There have been a lot of gun safety laws passed since then that are still standing, including six gun safety the Virginia General Assembly in early 2020
But I was speaking of this particular set of Justices.
@Anonymous At Work:
I can imagine a researcher wanting to know if such an event is correlated with an uptick in cirrhosis and early deaths among insurance executives.
Only if you consider they might, and I do mean MIGHT start considering the people who hand over all the bills over the people that collect a rather handsome level of compensation for doing almost as little as possible for those bill payers – their customers.
The ACA let us retire 3 years earlier than65. Husband is now on Medicare and I will be in July. Thank you ACA for the huge gift that affordable (with subsidies) gave us!
That doesn’t mean the money hoarders still don’t want to end it because it takes away some of their pompous arrogance of being the people that get actual medical care, while all the peons suffer. Also it might just impact their bank accounts by a few cents….
I have owned a business with employees and we paid health care insurance for them because it was a lot cheaper for us to purchase a policy that covered everyone than to pay them enough to purchase their own. And yes I got the advantage as well. It was a welcome benefit for all. But the ACA makes it a lot better for everyone, even those who do not directly benefit. When we all have better health because we can actually afford it, it changes the entire population.
This country is about money, freedom to have a lot of it and freedom to have none. I know that is a bit out there as a concept but think about all the things that money buys and all the things that not money does not, and health care is one of those. And health care affects all of us. Think about the last 3 yrs and a disease that is very highly transmittable and kills, that we are still living with. What if the vaccine cost $100 or $200/dose? How many people would have not gotten it, not because they thought that horse medicine would be better, but because they couldn’t afford it?
SCOTUS justices who are true believers don’t necessarily care. But Republican politicians would pay.
Anonymous At Work
@David Anderson: Be a good excuse to spend grant money to fly out to SLC and California. But yes, that would be a big task.
I am looking forward to reading preliminary results from that analysis, whomever does it. Generics are the ultimate stick for insurance companies, PBMs, and sock-puppet PBMs (looking at you, Optuum RX)!
Anonymous At Work
@Ruckus: Generics would mean that executive compensation suddenly gets a lot smaller and the executives could not afford the same quality of hookers and blow as they once were. As a result, many turn to cheap alcohol, like Johnnie Walker Blue.
That may be the case, but it’s the three Skagit River dams that have been in the news here a lot. (For non-PNW-ers, that’s pronounced “SKA-jit”, not “skag-it”, and “Skajit” rhymes with “gadget”.)