A Great Day for America

President Obama today signed the Affordable Health Care for America Act. It was a moment that will go down in history alongside presidential signings into law of Social Security, Medicare, the Civil Rights Act and the Voting Rights Act as red-letter days in American social history. It is now a fundamental American principle that access to health care is a right, not a privilege.

The nature of the thirteen-month fight just concluded has been instructive. On one side were people determined to solve a serious problem in national life. They wanted to make it possible for every citizen to get the care they need when they get sick or injured and to get regular checkups to maintain their health. They wanted to do this while decreasing the national deficit. It was a tall commitment to accomplish both at the same time. They were intent on working with all their colleagues on both sides of the aisle to make this happen. As evidence of this intent, they incorporated over two hundred of the minority-party amendments suggested in committee into the final bill. The congressional committee chairmen worked long and hard to try to meet minority party concerns. For his part, the president himself hosted numerous meetings and attended the opposition caucus in a long and thorough effort to invite bipartisan cooperation.

On the other side were people determined that nothing should be done. They announced their intention to impede any action early and often. They pretended to negotiate, later admitting (Charles Grassley) such was just for show in an attempt to stall the process. They appealed primarily to fear and invented references to "death panels" (Sarah Palin) and "Soviet totalitarianism" (Devin Nunes, R-CA, my own Congressman) to whip up hatred and panic and demonize their opponents. They refused to introduce a serious proposal of their own.

Consequently, the Congressional Budget Office analysis found that the majority plan would cover 32 million people at a savings of $138 billion the first ten years and $1.2 trillion the second. The minority plan would cover only 3 million people at a savings of $68 billion the first ten years. It was not a serious proposal to solve the problem of uninsured Americans. That final non-partisan analysis of effectiveness combined with savings pushed the effort over the top with wavering legislators and the bill passed.

Confident of public antipathy toward the bill, the opponents are vowing to carry on the fight and to work for its repeal. See, for example, John McCain's statement. In one extremely enlightening comment, Newt Gingrich even said passage of the bill may do as much harm to the Democrats' election chances in the South as the passage of the Civil Rights Bill did in the 1960s. But the many benefits kicking in right away are making people reconsider. Among these are the tax cuts for small business to provide coverage, a $500 reduction in the Medicare "doughnut hole" for seniors, young people being able to stay on their parents' coverage until their 26th birthday, the banning of rejecting children from coverage because of pre-existing conditions, forbidding anyone from being dropped because they get sick or exceed a predetermined "cap" on services, a new high-risk pool for adult uninsured with pre-existing conditions and increased funding to graduate more primary-care physicians. More will be added as the years go by, such as the extension of the pre-existing conditions language to everyone and subsidies to help families making less than $88,000 to buy insurance. Of course, increased taxes on individuals making over $200,000 and families earning over $250,000, and a mandate to buy coverage will kick in too. These, though necessary to fund the program, will displease some, without question.

But still, we are already seeing indications that the opponents may have overplayed their hand. The reaction to the bill's passage has already created a big shift in public opinion. A Gallup Poll released today finds that 49% feel passage of the health care bill is a "good thing" and only 40% regard it as "a bad thing." Though facing furious conservative resistance when enacted, Medicare, Social Security and Civil Rights are now considered cornerstones of American society and essential foundations of the nation's social compact with its citizens. There is every likelihood the Health Care Act will one day be regarded in the same way. After the presidential signing ceremony this morning, a card left at the grave of the late Senator Edward M. Kennedy by his son Representative Patrick Kennedy said it all: "Dad, today the unfinished business got done."