The Magazine

A Slight Case of Bastardy

The curious and irregular conception of Obamacare

Mar 3, 2014, Vol. 19, No. 24 • By NOEMIE EMERY
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A number of apologists for the Obama administration declare themselves vexed at the ongoing hostility to the Patient Protection and Affordable Care Act (which isn’t affordable, and from which many people are seeking protection), regarding resistance to its charms as a perverse and irrational gesture, uncalled for, eccentric, and strange. It’s the law of the land, they tell us, passed fair 

The lies just keep on coming.

The lies just keep on coming.

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and square by both houses of Congress, crowned as constitutional by the highest court of the country, and ratified by the people in Obama’s reelection. They note that other historic reforms—Medicare, Social Security—had troubled beginnings and then were embraced by the nation, and that even the Civil Rights Act of 1964, preceded by outbreaks of terrible violence, was accepted quite quickly once passed.

Not so with Obamacare, to which resistance over time has only grown stronger. “Current and former administration officials .  .  . have been surprised at how steadfast the opposition has remained,” the Washington Post reported last summer, quoting MIT economist Jonathan Gruber saying, “It used to be you had a fight and it was over, and you moved on.” But few have moved on, for reasons which are not all that hard to tease out: It’s not working out, in fact it’s a disaster; it’s blowing holes in the federal budget; the win-to-lose balance is way out of kilter, as many more people are hurt than helped by it. Obamacare may collapse on its own for practical reasons, but there is a fourth strike against it that adds a dimension of weakness no comparable measure has faced: Much of the country believes it’s a fraud, passed dishonestly, and not deserving of moral authority. In short, they find it nearly illegal, highly immoral, and possibly fattening. And their minds won’t be changed.

There are written rules that make an act legal, and unwritten ones that make it legitimate, and it is the latter ones this act fails. Medicare, Social Security, and the Civil Rights Act had four things in common that made them iconic: They embodied a popular consensus that was strong if not universal; they were passed by large margins with bipartisan backing, which meant their appeal crossed many factions; they were transparent and easy to follow, so the country and Congress could make informed judgments; and they were passed by the usual order of legislative business. The Affordable Care Act, on the contrary, was passed with public opinion running strongly against it; it was passed by the minimum number of votes in the House, with no Republicans voting for it; it was passed through the Senate via a loophole, as it could not have passed through normal procedures; and it was so complex, convoluted, and incomprehensible that its contents were a mystery both to the voters and the members who passed it, and remained so until last October, three and a half years after it passed.

Medicare and Social Security were relatively simple transfers of money, paid for with taxes and given to those deemed eligible for them by virtue of circumstance, and the civil rights laws were even more simple: They gave back rights to black citizens that had been taken from them by prior government and citizen actions. Obamacare, on the other hand, was a huge, complex bill of more than 2,000 pages that aimed to remake a vast, complex health insurance system, and created large numbers of winners and losers, in ways that few understood. Much of this ignorance was created on purpose, with the full rollout suspended for years, presumably until after Obama had been reelected and the furor surrounding its passage had wound down. 

“The White House systematically delayed enacting a series of rules on the environment, worker safety, and health care to prevent them from becoming points of contention before the 2012 election, according to documents and interviews with current and former administration officials,” the Washington Post reported in December.

Some .  .  . were instructed to hold off submitting proposals to the White House for up to a year to ensure that they would not be issued before the voters went to the polls. .  .  . [S]talled regulations included crucial elements of the Affordable Care Act. .  .  . The Obama administration has repeatedly said that any delays .  .  . were coincidental, and that such decisions were made without regard to politics. But seven current and former administration officials told the Washington Post that the delays were clearly political.

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