Opinion | Bidencare is a big deal


In 2010, at the signing of the Affordable Care Act, also known as Obamacare, Joe Biden, the vice president at the time, was caught on a hot microphone telling President Barack Obama that the bill was a “big deal.” . Well, actually there was another word in the middle. Anyway, Biden was right.

And in one of his major unsung accomplishments (it’s surprising how many Americans believe an unusually productive president hasn’t done much) President Biden has made Obamacare an even bigger deal, in a way that is improving the lives of millions of Americans.

As you may have noticed, as many Americans finally seem to be noticing, Biden has been putting up some pretty good numbers lately. Economic growth continues to advance, defying widespread predictions of a recession, while unemployment persists. close to a minimum of 50 years. Inflation, especially using the Federal Reserve’s preferred measure, has fell near the Federal Reserve’s target. The stock market continues to reach new highs.

Oh, and murders have plummeted, and violent crime in general is likely to affect another minimum of 50 years.

Biden deserves some political reward for this good news, given that Donald Trump and many members of his party predicted economic and social disaster if he were elected, and that Republicans, in general, still talk as if the United States is suffering from high inflation and rampant crime. . (Trump, of course, has been dismissing the good jobs numbers are false. Wait until you hear about the crime drop.)

It is less clear to what extent the good news on these fronts can be attributed to Biden’s policies. Presidents definitely do not control the stock market. In general, they have less influence on the economy than many believe; I would give Biden some credit for the strength of the economy, which was driven in part by his spending policies, but the rapid deflation 2023 primarily reflects a nation working its way out of the lingering disruptions caused by the Covid pandemic. The same is probably true of the drop in violent crime.

However, one area where presidents make a big difference is healthcare. Obamacare, which should really be called Pelosicare, since Nancy Pelosi (who is not, whatever Trump thinks, the same person as Nikki Haley) played a key role in getting it passed in Congress, led to large profits in health insurance coverage when it came into full effect in 2014.

Trump tried unsuccessfully to repeal Obamacare in 2017, and the reaction That effort helped Democrats win control of the House the following year. However, Trump was able to create some erosion in the program, for example by cutting funding for “navigators” who help people enroll.

That erosion has now been decisively reversed. The Biden administration just announced that 21 million people have signed up for coverage through the ACA health insurance marketplaces, up from about 12 million on the eve of the pandemic. The United States still does not have the universal coverage standard in other wealthy nations, but some statesincluding Massachusetts and New York, have come closer.

And this gain, unlike other good things happening, depends entirely on Biden, who restored help to people seeking health coverage and improved a key aspect of the system.

Obamacare is not simple. Many of the health economists I know would have preferred something like Medicare for All, if it had been politically feasible. But it wasn’t and isn’t, so what we have instead is a sort of Rube Goldberg device, a combination of devices designed to expand access to health care with minimal disruption to existing arrangements. Those markets, where insurers are prohibited from discriminating against people with pre-existing conditions and buyers receive subsidies to help them pay premiums, are a key part of the system.

It’s not an ideal mechanism, but it’s much better than nothing. However, the markets were originally underfunded: the subsidies were too low, so many people still had trouble paying insurance premiums, and there was also a limit, with subsidies available only to individuals up to 400 percent. of the poverty line.

Biden, as part of the Inflation Reduction Act of 2022, largely resolved these problems, reducing maximum premium payments (net of subsidies) and removing the cliff at 400 percent. The result is to make health insurance coverage substantially more affordable, especially for middle-income Americans who previously earned too much to be eligible for subsidies. Hence the increase in registrations in the market.

I don’t know if healthcare will be a major issue in the 2024 election. But it should be.

Biden has made health insurance coverage more accessible and affordable for millions of Americans.

However, if Trump wins, he will try again to end Obamacare; He has said it and this time he could very well achieve it. He promises to replace it with something “MUCH BETTER.” I guess this depends on your definition of better: In 2017, the Congressional Budget Office estimated that Trump’s health plan would increase the number of uninsured people by 32 million within a decade; that number would probably be higher today.

One more reminder of what is at stake this year.

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