Not So Surprising, In Retrospect


It did not come upon the midnight clear- it was an evening, in fact. But we were told the event was nearly as transforming as

For lo! the days are hastening on, by prophet-bards foretold,
When with the ever circling years comes round the age of gold;
When peace shall over all the earth its ancient splendors fling,
And the whole world send back the song which now the angels sing.

What better time to be reminded of a Christmas hymn than when much of the country is suffering from sweltering heat and humidity? And weren't we informed "lo! the days are hastening on.... comes round the age of gold"? The Associated Press reported on March 22:

A transformative health care bill is headed to President Barack Obama for his signature as Congress takes the final steps in Democrats' improbable and history-making push for near-universal medical coverage.

On the cusp of succeeding where numerous past congresses and administrations have failed, jubilant House Democrats voted 219-212 late Sunday to send legislation to Obama that would extend coverage to 32 million uninsured Americans, reduce deficits and ban insurance company practices such as denying coverage to people with pre-existing medical conditions.

"This is what change looks like," Obama said later in televised remarks that stirred memories of his 2008 campaign promise of "change we can believe in."

"We proved that this government -- a government of the people and by the people -- still works for the people."

Transformative, improbable, history-making, "change we can believe in" from "a government of the people and by the people." That seemed almost as good as was a birth, even more improbable and transformative, in Bethlehem.

But the Affordable Care Act has been beset by numerous challenges, in the courts and in Congress. Sebastian Jones describes the effort by both the Republican Party and the Democratic Party to destroy the Independent Payment Advisory Board established by the Act:

a little-known Democratic congresswoman named Allyson Schwartz signed on as a cosponsor of Roe’s bill. Her defection was enough of a partisan hiccup to earn some prominent ink in the Beltway press. An article that landed on the cover of the New York Times in mid-April suggested that conscientious opposition to IPAB was becoming an issue that crossed the political aisle.

What Schwartz’s defection really represented, however, was not the MacGuffin of earnest bipartisanship but a serious moment of escalation in a war that the medical industry is waging against the lynchpin of President Obama’s health care reforms. To understand why, it helps to know a little bit about Schwartz and who she represents. A former health care executive from a suburban district outside Philadelphia, she is the health policy brains of the New Democrat Coalition, a group of forty-two House members whose close relationship with several hundred Washington lobbyists has made them one of the most successful political money machines since the Republican K Street Project collapsed in 2007. In the past several years, they have played an instrumental role in helping the financial and health care industries limit and weaken proposed reforms; IPAB would appear to be their next target. And if the history of the group is any indication, where Schwartz goes, the votes of a substantial number of her New Democrat colleagues are liable to follow.

Schwartz is "little known" but has become much more than a back-bencher. She has been tapped by Democratic National Committee chairwoman Debbie Wasserman Schultz to head candidate services for the DCCC, in which role she appears to be recruiting centrist and/or pro-corporate Democrats to run for the House. So Digby remarks

I continue to be surprised that the administration is allowing so much play on the health care reforms. If that is his signature legacy you'd think he would exercise strong control over the Democrats on this one issue if nothing else. Certainly, the president is the head of the Democratic Party and could nix a big promotion of someone who is leading the charge to destroy the most important piece of the cost savings in the reforms if he wanted to. I don't get why any of this is on the table. Particularly when the stakes are this high.

Neither did I, less-connected, insightful, or eloquent (and far less pithy) than Ms. Parton, see coming the President's apparent acquiescence in the effort to chip away at his signature accomplishment. (Although this probably has been the President's most important- and first- achievement globally, one subject to reversal by any future President.)

But it was probably naive. The PAD may be revoked by Congress, the insurance mandate junked by the Court, or the Act defunded, but the Affordable Care Act itself is highly unlikely to be rescinded. And would it still not be historic? Would it still not stand as an accomplishment which Presidents Roosevelt, Truman, Kennedy, Johnson, Carter, and Clinton did not achieve? Would it not still be the "landmark health-care legislation" the Washington Post characterized on the afternoon of March 22, 2010 the President would be signing into law the following day? Its impact may prove to be less transformative than minimal- or even detrimental- but the President would have achieved something he and his supporters have claimed for him since March 21, 2011.

And isn't that what it was mostly about?

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