Take note of this number: 7.1 million. It’s going to change the conversation about the Affordable Care Act – also known as Obamacare.
You will hear that number over and over again, largely from Democrats touting the last-minute surge in sign-ups for the federal health insurance program that Republicans have been trying to abolish for four years. And whether the number is precisely correct or not doesn’t really matter.
The debate about the Affordable Care Act has been almost entirely one of politics and perception from the start. It has been portrayed by Republicans as creeping socialism, a program that will take away your right to choose what kind of medical care and which doctors you want, and then, at the end of your life, a death panel will decide how much longer you get to stick around.
Democrats are guilty of their own exaggerations. Not everyone will have lower premiums under Obamacare, and some will lose policies they like because they don’t conform to ACA standards. Sign-up won’t be a click away on the computer. And, even if you like your doctor, you won’t necessarily get to keep him or her.
Largely forgotten in this surface-skimming debate is that the ACA was not a plot to inflict socialized medicine on America. The ACA was an effort to extend health insurance to roughly 45 million uninsured Americans using a system devised by the conservative Heritage Commission and successfully tested in Massachusetts.
The goal was both to help people in need and make the nation’s health care system more efficient and less expensive for all. The ACA also was designed to help America join the rest of the industrialized world in providing affordable insurance options to all citizens.
But the details were complicated. For critics, it was much easier to simply vilify Obamacare as a hopeless mistake and pledge to repeal it.
In fact, House Republicans actually have voted 50 times to repeal it. And that tactic has been political gold for them – to the extent that the anti-Obamacare theme provides the foundation for their entire strategy for this year’s mid-term campaign.
The White House did its part to help by producing the most disastrous roll-out of a federal program in memory. The GOP needed a script for the helplessness of Big Government, and the White House wrote it for them.
But that number – 7.1 million – changes everything. In the nail-biting lead-up to the March 31 deadline for signing up for Obamacare, Democrats sought cover for the inevitable failure to meet the goal of enrolling 7 million Americans.
It just wasn’t going to happen. And then it did, with 100,000 or so to spare, not to mention another 4.5 million enrolled in the expanded Medicaid program and hundreds of thousands of children up to age 26 enjoying coverage on their parents’ plans.
Democrats were justifiably ecstatic. The American people – including millions of procrastinators, foot-draggers and folks who wanted to wait as long as possible to pay their premiums – came through in the nick of time.
Obamacare still is full of flaws. It is administered through different exchanges in different states. It doesn’t offer enough options to customers. It could be a hardship for some employers.
Those things need to be fixed. But it’s now clear – because of that 7.1 million figure – that Obamacare won’t be repealed, that the government is not going to take away the insurance coverage millions of people went to the trouble of signing up for.
And one recent poll shows that, for the first time, more Americans view Obamacare positively than negatively. The tide might not turn in time to save the Democrats in the fall elections, but Obamacare is here to stay.
The debate still isn’t about the details; it’s about perceptions. But the Republicans said Obamacare would fail, and it didn’t.
In the end, 7.1 million people signed up for Obamacare. It’s that simple.
James Werrell, Herald opinion page editor, can be reached at 329-4081 or, by email, at firstname.lastname@example.org.