The push for health care reform started, decades ago, as the number of Americans without access to health insurance grew. In 1999, 37.7 million didn’t have health insurance, according to census figures. By 2010, more than 49 million couldn’t get, or couldn’t afford, insurance.
But solving the health care problems of millions of voters somehow got lost once a Democratic president launched his health care initiative.
Coverage for the uninsured, while still the heart of what has come to be called Obamacare, was drowned out by arguments over “death panels,” the constitutionality of the individual mandate and the size of government.
Once Obamacare was signed into law, Republicans in Congress fought to repeal it, states petitioned the Supreme Court to overturn it, and GOP governors vowed to stop it from coming to their states. The Supreme Court gave them an option, declaring that the federal government couldn’t force states to expand their Medicaid programs to cover more of the uninsured.
But the urge to help people still motivates most politicians, whatever their party. And with the feds paying 100 percent of the cost of expanding Medicaid in the first three years — and at least 90 percent after that, it’s hard for any governor to explain to people that — purely as a matter of political principle, they can’t go to the doctor when they get sick.
So Republican governors are finally starting to get it. In eight states, including Ohio, Michigan, Arizona and now New Jersey, GOP governors have reversed their positions and decided to let the feds pay to expand Medicaid in their states. Their change of heart, some of the governors said, came when last year’s Supreme Court ruling and last November’s election convinced them that Obamacare was here to stay.
But the governors also put their actions in moral terms up until recently mostly voiced by Democrats.
“No mother or father should despair over whether they have access to high quality health care for their sick child,” Florida’s governor Rick Scott said recently. “I cannot in good conscience deny Floridians that need it access to health care.”
Scott, a former health industry executive elected on a platform opposing Obamacare, has seen his popularity fall dramatically. His flip-flop might also have been influenced by Floridians’ rejection last November of a referendum declaring the state’s opposition to federal health care mandates.
The rollout of Obamacare has taken longer than we might wish, with its most important provisions — the mandate, subsidies and insurance exchanges through which the uninsured would gain access — not going into effect until 2014. That has allowed the partisans to fight over principles and trivia without acknowledging the families that will be immeasurably helped by a more humane health care system.
Now that the law’s benefits are coming into sight, Republicans, at the state level at least, are starting to think in terms of making Obamacare work instead of making it fail. That’s a good sign.