What we’ve gained from the Affordable Care Act, 13 years later

Do you remember when some senior citizens had to ration their medicines because their prescription drug costs would triple every year after they entered the Medicare coverage gap known as the “donut hole”? I do.

Do you remember when turning 19 meant getting kicked off your parents’ health insurance plan, regardless of your living situation? I do.

Do you remember when insurance companies could refuse to pay for preventive treatments — vaccinations, mammograms, colonoscopies or countless other essential services — for any reason, or perhaps no reason at all? I do.

Do you remember insurance companies refusing coverage to pregnant women or others with “preexisting conditions”? Or when they could charge you what they wanted, for whatever reason they wanted, and you really had no choice but to accept that because there was no Patient’s Bill of Rights? I do.

But those days were relegated to the dustbin of history on March 23, 2010, when President Obama signed the Affordable Care Act (ACA) into law. Of course, as we mark the ACA’s 13th anniversary, it’s easy to forget the political costs of that “miracle” legislation. 

To begin with, it took years for Congress to draft and vote on the health care law. Then, the GOP made repealing the ACA its priority in the 2010 midterm elections. They demonized the law — labeled as “ObamaCare” — threw in a couple of racist dog whistles and, with a nationwide disinformation campaign, rode a wave that won them back control of the House of Representatives and flipped 12 governor’s offices, including Ohio, Pennsylvania, New Mexico and Michigan. This ushered in an era of obstructionism that defined Congress for several years.

In fact, the GOP-controlled House voted more than 50 times to repeal the ACA, ignoring the tens of millions of Americans who got health insurance, and countless others who have benefitted from the Patient’s Bill of Rights. Ironically, the single-minded devotion that won Republicans the House majority in 2010 would cost them that majority in 2018, following a systematic education campaign that took the debate from abstract political philosophy to one centered on concrete reality.

A reported 13.6 million Americans got insurance in 2021 alone via that ACA marketplaces. Closing the prescription drug “donut hole” saved millions of Medicare recipients billions of dollars, and 2022 surveys by the Kaiser Family Foundation and Morning Consult found that a majority of Americans approve of the ACA. Staunch Republican opposition is shrinking.

It turns out that public opinion is even more striking when you ask folks about specific ACA provisions. For example:

• 90 percent of Americans support prohibiting health insurance companies from denying coverage for people with preexisting conditions;
  
• 89 percent support requiring health insurance companies to cover the cost for most preventive services;
  
• 88 percent support prohibiting health insurance companies from denying coverage to pregnant women;
  
• 87 percent support prohibiting health insurance companies from charging sick people more, and the same percentage support giving states the option to expand Medicaid;
  
• 85 percent support providing financial help to low- and moderate-income Americans to purchase coverage; and
  
• 78 percent support allowing young adults to stay on their parents’ insurance plans until age 26.

More than 35 million Americans have health insurance today because of the ACA — men, women and children who are benefiting from lower cost and higher quality health care coverage. They can thank the vision and courage of leaders such as former House Speaker Nancy Pelosi (D-Calif.), former Majority Leader Steny Hoyer (D-Md.) and former Majority Whip Jim Clyburn (D-S.C.), who socialized the issue and worked to secure the history-making votes in Congress.

These men and women of conscience knew that “an ounce of prevention is worth a pound of cure,” as the old Ben Franklin saying goes. They passed the most consequential health care legislation of my lifetime, proving that the age of heroes has not passed and that, in the words of Abraham Lincoln, our “government of the people, by the people and for the people shall not perish from the earth.”

Do you believe in miracles? I do.

Antjuan Seawright is a Democratic political strategist, founder and CEO of Blueprint Strategy LLC, a CBS News political contributor, and a senior visiting fellow at Third Way. Follow him on Twitter @antjuansea.