Why The COVID-19 Bill Is Such A Big Deal
And What Democrats May Have Learned from The Ten Year War
Joe Biden famously called the Affordable Care Act a “big f***ing deal.”
The new COVID-19 relief bill, which the Senate passed on Saturday and the House is likely to approve this week, looks like it’s a pretty big deal too.
My new story at HuffPost has the details. The $1.9 trillion bill includes a variety of measures, like direct cash assistance and a higher child tax credit, designed to help the economy and sustain individual Americans until the pandemic ends. It also has much-needed funding for testing and vaccinations, and for child care and schools so that they can operate safely while the virus is still circulating.
But I want to focus on yet another part of the bill, one that hasn’t gotten so much attention. It’s a substantial increase in the financial assistance available to people buying health insurance through the Affordable Care Act’s exchanges.
Those who don’t get tax credits already, because their incomes are too high, will now be eligible for some assistance. And those who already get assistance will be eligible for more. (In both cases, it will depend on specific circumstances; Charles Gaba, the Michigan-based analyst, has a more detailed breakdown.)
These are precisely the sorts of upgrades that the Affordable Care Act has always needed.
As I recount in THE TEN YEAR WAR, most of the law’s architects wanted to make the financial assistance more generous in the first place. But that would have required more funding, which meant (a) finding offsetting taxes or spending cuts and (b) overcoming resistance from conservative Democrats who were eager to limit government spending, except maybe when it was of special help to their own constituents.
Obama and Democratic leaders hoped they’d get a chance to make those improvements later, so they could spruce up their “starter home.” But with Republicans opposed to anything that helped “Obamacare,” Democrats haven’t had a chance to take those steps. Until now.
The ability of Biden and allies to pass these improvements, with just 50 senators in the Democratic caucus, suggests they learned some of the political lessons of 2009-10 — including the need to move quickly on legislation, rather than spending months in futile negotiations with Republicans who will never get to “yes.”
Of course, the progress comes with a big asterisk. The boost in ACA subsidies, like the rest of the COVID relief measures, is temporary. Making it permanent, as Biden and Democrats have said they hope to do, will require another piece of legislation.
But this weekend’s success could become habit forming, as Democrats come to recognize how much they can accomplish if they stick together. And accomplishments like these could reinvigorate progressive politics over the long-term, as my HuffPost dispatch explains:
One of the biggest, most under-appreciated impediments to much of the Democratic Party’s agenda these days is a lack of faith in the public sector. In the mid-1960s, more than three-fourths of Americans trusted the federal government to do the right thing most of the time, according to polling from Pew Research. Today, around one in five do.
There’s no simple or single explanation for why faith plummeted as much as it did, just as there is no quick, surefire way to revive it. But if the COVID-19 bill does what it’s supposed to do, it will provide critical financial relief, shore up child care services, make health insurance more affordable, and underwrite a vaccination effort that could reach most of the country by the summer.
Those things can only help remind people of government’s ability to improve people’s lives. And if that happens, Democrats could have a chance to do much more.
California Dreamin’ on the Virtual Book Tour
Last week’s tour for THE TEN YEAR WAR included an online event hosted by the Commonwealth Club of California, which is based in San Francisco.
This was another instance when I was really bummed the visit had to be virtual. I've spent a lot of time reporting there over the past few years and stories from the state figure prominently in the book.
There's a reason for that. California is one of a small handful of states where officials did exactly what the ACA's architects intended: They embraced the new program wholeheartedly, moved quickly to set up an infrastructure, and then managed it aggressively. As a result, it's really become a showcase for Obamacare at its best, although it's also reminder that, even at its best, Obamacare still has some serious inadequacies.
The event’s moderator was Anthony Wright -- which was appropriate, because he's one of the people who first taught me about health care in California and continues to be a vital source of wisdom on the subject today. I've been trying to think when he and I first met and I'm not sure because it was such a long time ago. But our paths have intersected frequently and, during the ACA legislative fight in 2009-10, I recruited him to be a regular guest blogger at The New Republic. (Here’s his final entry, which proved to be quite prescient.)
Few people can speak with such first-hand knowledge about health care policy and politics, because the group he runs, Health Access, is heavily involved both on the front lines and in the legislatures (i.e., state and federal). Anthony is also a great human being, even though he is a well-known fan of a baseball team that makes its home in the Bronx. I try not to make him feel bad about that. Mostly.
The Commonwealth Club has its own bookshop, where you can buy THE TEN YEAR WAR if you don’t have a copy. Here’s the URL: https://bookshop.org/books/the-ten-year-war-obamacare-and-the-unfinished-crusade-for-universal-coverage/9781250270931?aid=18063&listref=recent-author-events
They’ve also posted video of the event, in case you missed and would like to watch:
Coming Soon
More virtual events for THE TEN YEAR WAR are coming, along with some media appearances. Reviews and profiles are also appearing in various outlets. Some of them raised important points (including criticisms) that are worth discussing.
But that’s for another day.
So stay tuned. And thanks for reading!
-- Jonathan