This week, we’ll mark the three-month point since the March 23 signing of the Patient Protection and Affordable Care Act (PPACA), and we’ll have lots about the impact it is already having, and the benefits to come.
But it also should be a reflection of passing of this historic legislation, and how it happened. Jonathan Cohn had a detailed write-up of “How They Did It” in The New Republic (most of it behind a paywall). It’s brain candy for those who went through it, complete with quotes of some of the insider conversations on Capitol Hill.
This and other accounts are important history and a great read, but I fear such inside reports may downplay the importance of the work done on the outside–the years of work to get health reform as a top concern, the leadership taken by key organizations and the selfless stances taken by key groups, the grassroots organizing by many across the country–to get this done. I hope that as this history is written, those components are taken into account and given their due.
But leadership matters, and it is instructive that this would not have happened without Speaker Nancy Pelosi, Senate Majority Leader Harry Reid, and in particular, President Barack Obama. Cohn downplays how much Obama was committed to health reform as a candidate–from his work in the Illinois legislature as chair of the health committee, to his decision to invest more than half of his fall advertising on health issues.
But Cohn confirms part of an incredible story: how President Obama stuck with health reform against the advice of the majority (if not most, if not all) of his advisors, on at least three separate occasions:
* After his winning the White House, but when others argued that given the economic crisis and other issues, health reform would take too much attention;
* After the August where so-called “tea party” activists worked to disrupt Congressional town hall meetings; and
* After the Scott Brown election in Massachusetts, which left the Senate below 60 votes and many members spooked about moving forward with reform;
In each of these moments, he was urged to abandon the effort to reform the health system, or significantly scale it back. But he stuck with his guns, and led the Congress to go with him.
Regardless of some policy disagreements along the way, the President and the White House deserve credit for sticking to the effort, as Californians start to see the benefits roll out.