The ACA at 11, Zeke Emanuel And A Special Book Event Tonight
Remembering the good times. And the ugly times.
Today is the 11th anniversary of the Affordable Care Act becoming law, which is a good time to take stock of the law's legacy -- what went right, what went wrong, what still needs to be done.
Those of you who have read THE TEN YEAR WAR or are familiar with it know where I stand. I think it’s a deeply flawed piece of legislation that nevertheless did a great deal of good, and will go down in history as the most important, far-reaching piece of domestic policy legislation in a generation.
But the book is also about politics. And one big theme is the evolution of the Republican Party into a party that, although skilled at generating outrage, has lost the ability to govern. That transformation is the subject of a new, feature-length adaptation of the book at The Atlantic.
The article, "Why Obamacare Survived," starts with a snapshot from the day after the 2016 election, as Obama White House officials are still coming to grips with Trump's election. The Affordable Care Act's days seem numbered, but a key adviser disagrees. Over beers, she tells her staff why she thinks the law will survive, surmising that Republicans don't have the clarity of purpose that Democrats had when they wrote the ACA -- and, no less important, Republicans haven't done any of the necessary prep work that legislation requires.
The adviser, Jeanne Lambrew, was right. And among those who realized it belatedly are several key Republican staff and officials whose quotes appear in the article. As they conceded to me, the GOP had no consensus on a replacement plan and no proposals that lived up their promises of better health care for everybody. And that was because they never took the task of formulating policy seriously.
“Republicans do taxes and national security," Brendan Buck, former GOP leadership aide, told me. "They don’t do health care.”
Dean Rosen, GOP health strategist/lobbyist, said Republicans suffered from "an intellectual simplicity or an intellectual laziness" and that it "bit us in the ass when it came to repeal and replace."
Brian Blase, former Trump White House health care adviser, said "Obviously, it is the case that there were not enough conversations about ‘replace.' "
The book has more quotes like that, including some from a former Trump cabinet official. And it’s a sign that at least some people in or around the Republican Party understand the level of rot that has set in — although, from the looks of things, they remain a minority.
Zeke And Betsy
Another former Obama administration official who was part of the ACA story is Zeke Emanuel, the physician and bioethicist and writer. Yes, that is a long list of titles. Zeke does quite a lot. As I note in the book, he’s also a foodie who, a few years ago, found time somehow to develop his own line of exotic chocolate.
It’s called the Zeke bar and I can attest that it is good, although I’m not sure it’s available for sale anymore. (Sorry, I cover health care, not food.)
One episode from the ACA saga featuring Zeke prominently is the controversy over “death panels,” which Republicans claimed were part of Democratic health care legislation. The lie originated with a conservative writer named Betsy McCaughey, who had first made a name for herself by spreading misinformation during the Clinton health care fight.
Journalist Timothy Noah, who remembers this episode as well as I do, excerpted that part of the book today at his Substack newsletter, Backbencher. Tim is author of one of my favorite books, the acclaimed The Great Divergence, which grew out of a series on inequality he wrote for Slate.
You might want to check out Tim’s newsletter and subscribe. (It’s free.)
Zeke And Me
I too will be marking the 11-year anniversary of the ACA signing, with a virtual event at 7:30 pm tonight through Words Bookstore in Maplewood, New Jersey.
Note the time (not 7 p.m., like the others). Also note that this is a special event with a special guest: Zeke.
This book event will be a bit different than the previous ones, because Zeke was part of the ACA story and because he will also be promoting one of his own books. It’s a collection of essays on the ACA, called THE TRILLION DOLLAR REVOLUTION, that he co-edited with Yale Law Professor Abbe Gluck.
It came out a year ago and I think it’s terrific, although I am biased because I wrote one of the essays.
The event is open to the public, like the others. Hope you can join us!
Click here for event info and registration
Click here to buy THE TEN YEAR WAR from Words Bookstore
Click here to buy THE TRILLION DOLLAR REVOLUTION from Words Bookstore