Face the facts of the Affordable Healthcare Act

The Supreme Court upheld it in June and the American people re-elected the man most responsible for it in November. As Speaker of the House John Boehner said last month, “Obamacare is now the law of the land.”

After years of heated and often inaccurate debate, this is a good time to take a deep breath and review some actual facts about the Patient Protection and Affordable Care Act of 2010.

Perhaps the major problems we had in Congress during the debates about the bill were the time and outside money spent creating controversies over things that were not actually in it. By the time the bill passed, most Americans were led to believe that it would cost $900 billion and add a crushing new element to the national debt. The exact opposite is true.

The nonpartisan Congressional Budget Office, which has for many years served as the final word on the budgetary impact of all spending bills for both Democrats and Republicans, found that because of projected revenue increases and cost reductions in the bill, it would “yield a net reduction in federal deficits of $130 billion over the 2010-2019 period.”

In other words, according to the single most respected bipartisan source of budget information, Obamacare is one of the largest deficit reduction bills ever passed by Congress.

Remember the “death panels” that were a big part of the debates in 2009? Death panels were those government committees that would decide whether Uncle Joe gets to live or die. Right?


What became known as the death panel provision was not a Democratic proposal. It was originally proposed by a Republican senator I hold in high regard, Johnny Isakson of Georgia. In an interview in the Washington Post, he explained: “In the health-care debate mark-up, one of the things I talked about was that the most money spent on anyone is spent usually in the last 60 days of life and that’s because an individual is not in a capacity to make decisions for themselves. So rather than getting into a situation where the government makes those decisions, if everyone had an end-of-life directive or what we call in Georgia ‘durable power of attorney,’ you could instruct at a time of sound mind and body what you want to happen in an event where you were in difficult circumstances where you’re unable to make those decisions.”

Given that common-sense analysis, Sen. Isakson proposed that insurers pay physicians for providing counseling to patients about what decisions they wanted to make about end-of-life care. But the howls of “death panel” proved to be too effective; the provision was removed and was not part of the bill that finally passed.

Misinformation dies hard, though. Just three months ago, an AP-GfK poll reported that 41 percent of Americans believed Obamacare “will create committees … that will decide whether [people] can get medical care.”

I was a part of the Democratic Senate caucus in late 2009 before the bill came up for a final vote. Most of us weren’t happy with different provisions and some were ready to vote against it.

At close to the last minute, former President Clinton and Vice President Biden made virtually the same arguments before us. No major bill that broke new ground had ever been perfect, they said. Both Social Security and Medicare were extensively revised over the years after they first passed Congress.

Every president from FDR to Clinton, they went on, had tried and failed to pass major health care reforms. President Clinton made the point that everyone knew we desperately needed reform in 1993, but after his bill failed to pass in 1994, it took 14 years before the issue came up again in Congress.

If the Affordable Care Act were not passed under a popular Democratic president with Democratic majorities in both houses, it would be a long time before another attempt was made.

Those who thought they could vote the bill down and then introduce a new, better bill were simply misreading the lessons of history. The caucus decided unanimously to do what Clinton and Biden advised: Pass the bill and then start work on perfecting it.

Certainly some will continue to argue that government should not be involved in health care, but a clear majority has now decided that it should. The debate about ending Obamacare is over. What we should do now, following the advice of former President Clinton and Vice President Biden, is to begin the hard process of perfecting it. To do that effectively, let’s dispense with the myths and misinformation and start dealing with facts and reality.

Originally published 1 December 2012 on delawareonline.com