After a year of political posturing and rancorous debate over healthcare, President Obama signed the Patient Protection and Affordable Care Act into law Tuesday, codifying reforms that will indelibly transform the insurance industry. This represents the most drastic form of federal action on domestic affairs since the institution of Medicare decades ago. While the partisan combat will likely continue, this moment belongs to the Democrats. In this victory that has eluded several administrations in the past, the passage of healthcare reform marks a monumental accomplishment for President Obama, Speaker Nancy Pelosi, and the Democratic Party.
At a time when 46 million people lack health insurance and rising premiums outpace the growth in wages, healthcare required far-reaching reform. Left to the status quo, more and more Americans would lose coverage due to soaring costs, and system inefficiencies restricting the quality of care would engulf the industry. And with retiring Baby Boomers mounting additional stress on providers, the situation called for bold and decisive action. This legislation puts America on track to solve these pressing issues by insuring 32 million people and enacting consumer protections that will counter the host of problems plaguing the system.
Debate over the law’s cost, however, has yet to fade, despite the nonpartisan Congressional Budget Office’s conclusion that it is fiscally responsible. In advancing their allegation that Democrats will add to the deficit, Republicans insist that the bill will cost Americans far more than the CBO report suggests. This claim is largely unfounded; in fact, the CBO regularly errs toward conservative estimates about cost savings because it fails to account for savings from intangible factors, such as better technology and systemic improvement. Considering these additional components, Harvard economist David Cutler estimates that the law may save hundreds of billions of dollars more than the CBO predicted over the next decade. Contrary to Republican claims, the law is indeed fiscally prudent and could actually close America’s widening budget gap over time.
In reality, although supporters hail this as an epic achievement, the final product is not ideal and the effort to reform a broken industry is far from over. Ultimately, millions of Americans will remain uninsured, a problem which deserves serious attention down the road. Also, while the new programs will bend the healthcare cost curve, it does not break it, and Congress must take further action to make insurance more affordable in the future.
However, in times like these, idealism must be tempered with political realism. Despite its imperfections, the bill represents the best possible product given the political climate of the time. With Mass. Senator Scott Brown’s game-changing election stripping Democrats of their supermajority in the Senate, party leaders acted wisely in compromising on secondary issues to achieve primary goals. For instance, although ideally the legislation would not include restrictions on federal funding for abortion, striking a deal proved necessary in order to gain the votes of pro-life Democrats, given the political circumstances. Leaders like Pelosi and Senate Majority Leader Harry Reid should be commended for their shrewd congressional savvy in crafting the best possible bill considering the complex interests they had to accommodate.
Even with the stellar efforts of their party leaders, though, the victory would not be possible without the audacity of individual Democrats in the House and Senate. Healthcare was a bitterly divisive issue, and the American public trended toward opposition to the bill. Democrats in more conservative districts who voted for the law jeopardized their popularity and possibly even their jobs. It is rare in this era of campaign individualism for politicians to place principles before reelection, and those Democrats who accepted this risk deserve recognition. Considering this political gamble, constituents in favor of the new healthcare law should show appreciation to their representatives at the ballot box come Election Day. These leaders put their careers on the line for their values, which merits sincere commendation.
Meanwhile, amidst the muddling political circus in Congress, Obama and his administration showed tenacity in refusing to forfeit their vision for reform. Campaigning on the promise of fixing America’s unfair and unsustainable healthcare system, Obama put reform at the top of his political agenda and did not allow the debate to disappear from the public consciousness. As calls to throw out the bill and begin from scratch grew raucous upon Brown’s stunning election in January, Obama and his team increased their efforts by appealing directly to members of both parties and their constituents. The Obama administration’s resolve and clarity of purpose throughout this yearlong struggle made possible the enactment of broad reforms for the sake of the American people.
One immediate consequence of this achievement is that it will finally free Congress to work definitively to address other important issues. While healthcare was a critical problem that deserved the highest attention, myriad others also merit scrutiny and action. Specifically, Congress should now focus its efforts on reforming financial regulations and energy policy. As for now, Democrats on Capitol Hill can relish their historic triumph in a battle that was begun over a century ago. This legislation is a tremendous achievement for the Democrats in Congress and signifies a victory of the highest caliber for Obama’s young presidency.
This article has been revised to reflect the following correction:
CORRECTION: March 29, 2010
An earlier version of the Mar. 26 staff editorial "How 'Bout Them Dems" stated that Harvard economist David Cutler estimates that the law may save hundreds of millions of dollars more than the CBO predicted over the next decade. In fact, Cutler predicted it will save hundreds of billions of dollars.
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