JONATHAN COHN JANUARY 19, 2011
Nearly a year ago, after President Obama signed the Affordable Care Act into law, I recalled the story of Gary Rotzler and what happened to him in the early 1990s. He had a college degree and a life pulled straight out of a Norman Rockwell painting: He had married his high school sweetheart and, together with their three young children, they were living in a tiny village at the foot of the Catskill Mountains.
Then he lost his job, with its health benefits, and went uninsured for two years while getting by with a series of part-time, temporary jobs. By the time he'd gotten benefits, it was too late to treat his wife's breast cancer, which had gone undiagnosed and would soon take her life. But it was not too late to run up five-figure medical bills that forced Gary, the young widower, to declare bankruptcy.
Gary was just one of hundreds of people I've interviewed over the last decade, in my efforts to learn more about the health care system. And the best available estimates tell us that he's just one of millions who have suffered great financial or physical harm since then because he couldn't pay for basic medical care. Every other developed country on the planet protects its citizens from this sort of devastation. And thanks to the Affordable Care Act, the United States is on its way to joining them.
It still is, thankfully. Today's House vote to repeal the Affordable Care Act is merely symbolic. The Senate will almost certainly not pass it and, even if it did, the president surely would not sign it.
But symbolism matters. It sends a message about values. And so it's worth considering what values this generation of Republicans has decided to embrace.
Over the last year, the Republicans have spent a lot of time arguing that the Affordable Care Act will cost too much, that it will micromanage care, that it will burden business with taxes and bureaucracy. The most outrageous claims, like the notion of government-run "death panels," have zero basis in fact. And even the less explosive arguments frequently rely on flimsy evidence. But the most remarkable thing about the Republican campaign against health care reform is what the advocates of repeal haven't said.
They never bothered to engage with the fundamental moral logic behind the Affordable Care Act--that a modern society guarantees everybody access to doctors, hospitals, and the treatments they provide; that it's wrong to sit by and watch people give up their savings, or their lives, just because they happened to get sick. The more serious Republicans have some ideas, yes, but nothing that would come remotely close to insuring 30 million people or bolstering coverage for the people who have it.
As recently as the last major debate over health care reform, in the 1990s, there were prominent Republicans with sincere interest in helping the un- and underinsured. Even today, you can find conservatives who feel the same way or who, at the very least, are honestly convinced that fiscal constraints put those goals out of reach. But the Republicans in the House? The ones who'd gladly run up red ink to finance more tax cuts for the rich? If they care even a little bit about the human casualties of our health care system, they haven't bothered to show it.
In 1965, the House passed H.R. 1, a set of amendments to the Social Security Act that, when signed into law, created Medicare. The designation of the bill as the legislature's first order of business was no accident. President Lyndon Johnson and his allies understood that Medicare was a moral imperative--that extending insurance to the nation's seniors, thus sparing them the familiar indignities and financial deprivations of illness, was among the most important things they would ever do as lawmakers.
Today's vote to repeal the Affordable Care Act was H.R. 2. It, too, was a deliberate signal that the leadership considered this a top priority. All 244 House Republicans voted for it. But this was a bill to take insurance away from millions and to weaken it for millions more.
History remembers what happened in 1965. I hope it remembers what happened in 2011, as well.
Update: I made some small revisions to give conservatives, as opposed to House Republicans, more credit for their good faith.