The Real Story of #8Million

Actually, it's a story of nearly 20 million, if you count everyone who has health insurance directly thanks to the Affordable Care Act. And it could be the story of nearly 6 million more, who are being denied health insurance by Republicans refusing to fully federally funded Medicaid in states they control. It's a story of tens of millions more, and millions of seniors who now have better coverage and no yearly limits on coverage.

But last week's big number was 8 million. The President announced that 8 million American have enrolled in private health insurance coverage through the exchanges, and in addition, 3 million more are covered under the Medicaid expansion, 3 million young adults can stay on their parents' plans, and 5 million who bought ACA compliant plans outside the exchanges.

I got an email with links to people telling their stories about finally being able to afford health insurance. The story of these millions, though, is more encompassing than those who gained coverage. The story of the single dad who can no longer be denied health care because of a pre-existing condition, the story of a small business owner who can no longer be charged more just because she's a woman, the story of a cancer survivor who no longer has to fret that in the third month of the year, she will have reached her annual limit from her insurer - all these stories are possible because of a story that is told far too rarely in the American discourse.

That story begins with a young, charismatic newly elected president of the United States for whom health care reform wasn't just a campaign promise but a deeply rooted cause from which he wouldn't waver even when his political advisers wanted him to retreat. It begins with the overwhelming election of a president who, in his own words, was willing to become a one-term president to make sure that never again does a mother have to think twice about taking her sick child to the doctor.

It's a story of courage, of overcoming an unprecedented campaign of obstruction, of decoupling progress from ideological checklists. This is a story I saw happen - this is a story I am a part of, and there are no stories of which I am prouder to be a part.

This story starts with that president who would not let go, but it takes shape through the brutal opposition of his opponents and the heroism of many in his party in Congress. This is a story about two views of power: one that sees power as an end and the other - the president's - that sees power as a means to transform people's lives in positive ways. Insane Republican opposition and yelling teabaggers marked the summer of 2009, as the health care debate rose to prominence.

But just as the Republicans moved into the insane asylum with the Tea Party, the ideological Left was sharpening its own proverbial knife to stick in the president's back - and more importantly, in the back of the best chance we had had in a half a century to pass health care reform. When it became clear that the Senate did not have 60 votes to pass a health reform law with a public option - as the House already had - a segment of the Left moved into high gear and demanded that the entire effort for comprehensive reform be abandoned. Heck, they even went on Fox News to try to kill health reform.

The synergy of the extreme Right and the ideologue Left almost did kill health reform. Just as the Right stuck to their fictions of death panels and government takeover, the Left's loudest voices created a fictitious reality of their own: that the most significant reforms to the health insurance marketplace ever amounted to nothing more than an evil ploy by a Republican-lite president to forcibly hand over 30 million new customers to the Death by Spreadsheets private insurance industry. Just as the Right protested the end of the worst abuses of the private insurance industry as the government strong-arming people's "freedoms" to choose crapsurance, the Left refused to concede that market regulations and market competition along with strengthening Medicaid, investing in community health clinics and providing subsidies to buy insurance would make insurance more affordable.

Then there was Scott Brown, elected on the message of killing Obamacare. That was a make or break moment. The Democrats had lost their 60-vote majority in the Senate, and as she had done so many times before, Nancy Pelosi stepped in to save the day. She held together the House Democratic caucus against the rage of the pouty Left, passed the Senate's version of health reform in the House, and then used the budget reconciliation process - set up brilliantly in the Senate by one of the Left's most reviled Democrats, Max Baucus - to improve the subsidies and other monetary aspects.

Health reform passed. In March of 2010, it finally became law against long odds, against the naysayers, against the advise of the political tea-leaf reader.

Were it that the journey ended there. We would be remiss if we didn't consider the price the president's party paid for the Affordable Care Act. With the Right angry from their inability to stop Obamacare and with the Left seething at the president's temerity to pass health reform by bypassing their pet items and aching to "teach him a lesson," the forces synergized again, once again to the benefit of the Right. As the Left - with its loudest voices advocating for this - sat home and the Right got out to vote for the same reason - to teach the black guy a lesson - Democrats not only suffered the worst loss in the US House in recent memory, we lost governorships and state legislatures all across the country.

That loss is something we are still paying for. Politically, the 2010 elections put in power in the states right wing Republicans who not only passed draconian laws destroying labor rights and women's rights, but also got to draw brand new post-census Congressional and legislative boundaries favoring the GOP. And it is primarily because of that loss that 6 million Americans who could have access to a fully public health insurance program - Medicaid - are being denied health care by their states. Lesson learned, don't you think?

Since then, the Affordable Care Act has survived a Supreme Court challenge - creating a rather unusual coalition of the Court's liberals with Chief Justice Roberts rather than the Court's "swing" vote Justice Kennedy.  It has systematically implemented its mandates one by one: making preventive care free - including cancer screenings and birth control, allowing young adults under 26 to stay on their parents' plans, eliminating benefit limits, making it illegal to drop people when they get sick, and finally, ending pre-existing condition discrimination and opening up marketplaces and tax credits for people to buy affordable health insurance.

Whether due to the persistent Right wing noise machine or because of the difficult launch of the exchanges online, not all of it went smoothly. But the president and his team never gave up. Every single day, they kept working hard - not so that the president can leave a legacy, but so that America can finally leave behind the shameful legacy of being the only industrialized country on earth that did not make affordable health care a right for all its people.

So they fixed the website. They got the message out. The president went on comedy shows and took flack from the flack jackets in the White House press room. And his team did the unthinkable - not only did it pass the revised CBO estimate of 6 million, lowered due to the web launch, it blew through the original estimate of 7 million, and ended up at 8 million.

Not only did 8 million people sign up, the cost curve has been bent further down - not just since the original CBO estimate in 2010, but its estimates last year. Lower than estimated premiums (WHAT? Competition reduces price??) have taken an additional $104 billion off the nation's debt over the next decade:

The 8 million people who signed up for health insurance through the exchanges - and everyone else whose life has been made better by the Affordable Care Act - are a testament to this story. They are a testament to the hunger for affordable health care in America, and they are a testament the most liberal view of power: that power is not for the sake of power but for using it to change lives. 

The Affordable Care Act is an unqualified success. Too many liberal commentators still feel the need to point out that it is "not perfect," - but I don't. Nothing is ever perfect. But the measuring stick for progress is not perfection: it is lives changed, costs saved, and difference made. In every one of those ways, Obamacare is a major success - the brightest success story in American health care policy since the advent of Medicare.

But behind every success story is the story of struggle, sacrifice, dedication and focus. The story of the 8 million is only possible because a president who now has a lot more gray hair than when this battle started picked his fight, focused and dedicated his time in office to the working stiff in America, and the sacrifice of the Democratic party to bring affordable health care to every American.

That is the real story of the #8Million.



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