Soon-to-be-candidate Obama, then an Illinois senator, was thinking about turning down an invitation to speak at a big health care conference sponsored by the progressive group Families USA, when two aides, Robert Gibbs and Jon Favreau, hit on an idea that would make him appear more prepared and committed than he actually was at the moment.
Why not just announce his intention to pass universal health care by the end of his first term?Thus was born Obamacare, a check-the-box, news-cycle expedient that would ultimately define a president.“We needed something to say,” recalled one of the advisers involved in the discussion. “I can’t tell you how little thought was given to that thought other than it sounded good. So they just kind of hatched it on their own. It just happened. It wasn’t like a deep strategic conversation.”
Obama was at first reluctant to embrace the issue, but gradually became convinced that health care reform would be his main legacy. The result of this evolution is now familiar. Rather than prioritize the Administration’s response to the recession, as most Americans were demanding, Obama pushed his health plan, ignoring the kind of resistance that led to Scott Brown’s election and jamming the bill through Congress.The Politico piece reads almost like an obit for the law, which seems premature. But it’s undeniable that the ACA as it currently exists is much different and much weaker than what Obama set out to achieve. This weakness stems from the political strategy Obama chose. A slower and more comprehensive public discussion process, combined with greater effort to find common ground with the GOP, wouldn’t have eliminated opposition; but it might have produced a bill that didn’t have to be delayed, modified, and restricted in the way the ACA has.Rising health care costs are still a problem waiting for solutions. Center-right wonks should learn from the ACA saga that coming up with a reform plan is the easiest part of the process. Achieving the right political strategy to get it signed into law and implemented is where the true challenge lies.