by Paul Krugman · August 4, 2017
A protest outside the Denver office of Senator Cory Gardner in June. Ross Taylor for The New York Times
I guess it ain’t over until the portly golfer sings, but it does look as if Obamacare will survive. In the end, Mitch McConnell couldn’t find the votes he needed; many thanks are due to Senators Susan Collins, Lisa Murkowski and John McCain (who turns out to be a better man than I thought), not to mention the solid wall of Democrats standing up for what’s right. Meanwhile, all indications are that the insurance markets are stabilizing, with insurer profitability up and only around 0.1 percent of enrollees unserved.
It’s true that the tweeter in chief retains considerable ability to sabotage care, but Republicans are basically begging him to stop, believing — correctly — that the public will blame them for any future deterioration in coverage.
Why did Obamacare survive? The shocking answer: It’s still here because it does so much good. Tens of millions have health coverage — imperfect, but far better than none at all — thanks to the Affordable Care Act. Millions more rest easier knowing that coverage will still be available if something goes wrong — if, for example, they lose their employer-sponsored plan or develop a chronic condition.
Which raises a big question: Why did the prospect of health reform produce so much popular rage in 2009 and 2010?
I’m not talking about the rage of G.O.P. apparatchiks, who hated and feared the A.C.A., not because they thought it would fail, but because they were afraid it would work. (It has.) Nor am I talking about the rage of some wealthy people furious that their taxes were going up to pay for lesser mortals’ care.
No, I’m talking about the people who screamed at their congressional representatives in town halls. People like, for example, the man who pushed his wheelchair-bound son, who was suffering from cerebral palsy, in front of a congressman, yelling that President Obama’s health care plan would provide the boy with “no care whatsoever” and would be a “death sentence.”
The reality, of course, is that people with pre-existing medical conditions are among the A.C.A.’s biggest beneficiaries, and would have had the most to lose if conservative Republicans had managed to repeal the law. And this should have been obvious from the beginning.
Beyond that, it’s now clear (as should also have been clear from the beginning) that very few people other than wealthy taxpayers were hurt by health reform, which was designed to disrupt existing health arrangements as little as possible.
Yes, around 2.6 million people who had individual policies with high deductibles and/or limited coverage were told that their policies were too skimpy to meet A.C.A. requirements. But they were offered the chance to buy better policies, and many of them probably received subsidies that made these better policies cheaper than their original coverage. Meanwhile, some young, healthy, affluent people saw their premiums rise. But predictions of mass harm were completely wrong.
Or if you regard statistical evidence as “fake news,” consider what happens every time Republicans call on the public to come forward with horror stories about how they’ve been hurt by Obamacare: The result keeps being an outpouring of support for the law, bolstered by tales of lives and finances saved by the A.C.A.
So once again: What was Obamacare rage about?
Much of it was orchestrated by pressure groups like Freedom Works, and it’s a good guess that some of the “ordinary citizens” who appeared at town halls were actually right-wing activists. Still, there was plenty of genuine popular rage, stoked by misinformation and outright lies from the usual suspects: Fox News, talk radio and so on. For example, around 40 percent of the public believed that Obamacare would create “death panels” depriving senior citizens of care.
The question then becomes why so many people believed these lies. The answer, I believe, comes down to a combination of identity politics and affinity fraud.
Whenever I see someone castigating liberals for engaging in identity politics, I wonder what such people imagine the right has been doing all these years. For generations, conservatives have conditioned many Americans to believe that safety-net programs are all about taking things away from white people and giving stuff to minorities.
And those who stoked Obamacare rage were believed because they seemed to some Americans like their kind of people — that is, white people defending them against you-know-who.
So what’s the moral of this story? There’s bad news and good news.
It’s certainly not encouraging to realize how easily many Americans were duped by right-wing lies, pushed into screaming rage against a reform that would actually improve their lives.
On the other hand, the truth did eventually prevail, and Republicans’ inability to handle that truth is turning into a real political liability. And in the meantime, Obamacare has made America a better place.