Saturday, April 18, 2015

The Fight to the Death Against Obamacare is Unprecedented

At 5:33 am on November 22, 2003, after hours of unprecedented vote wrangling, the US House of Representatives passed the Medicare Modernization Act, President George W. Bush's landmark health legislation.

The Fight to the Death Against Obamacare is Unprecedented

Medicare Part D, a key component of the bill, provided prescription drug benefits to seniors for the first time. The bill was opposed by virtually all Democrats over concerns that its more than $400 billion price tag wasn’t paid for and over restrictions that prohibited the government from negotiating discounts with pharmaceutical companies that could reap a huge windfalls from newly insured seniors.

In the battle over the Medicare prescription drug benefit, one party used its majority to run roughshod over its opposition. Sound familiar? What’s different is what happened after the law went into effect in 2006. Former foes worked to support the law however grudgingly. There were no efforts to “kill the bill.” No threats to shut the government down unless the law was gutted.

Even after the Bush administration botched the rollout, Democrats didn't demand the president repeal the law and start over. In fact, Democrat-led states like New Jersey spent millions to cover the prescription costs for needy people while the federal government got its act together. Organizations that had opposed the bill counseled seniors on how to enroll and navigate the difficult application process and its infamous “doughnut hole,” and they advocated for improvements to the law. 

With the Affordable Care Act (aka Obamacare), it’s a different world. Republican states are barring navigators from state facilities and challenging government media campaigns to promote the new federal benefit. Governor Chris Christie is ignoring the state's reputation as a strong insurance regulator. Instead, he's letting the federal government implement the crucial health insurance marketplace (aka exchange), the place where low-income New Jerseyans eligible for subsidies can purchase their coverage. As a result, New Jersey has received just $2 million to inform its citizens about their new health insurance options versus the $27 million that New York is spending. Even worse, Governor Christie has thus far refused to use several million dollars in unspent health insurance exchange setup funds to market this valuable benefit. The situation in Pennsylvania is no better.

Obamacare is the law. It’s time for the opponents to lead, follow or get out of the way. If uninsured people miss the opportunity to get subsidized life-saving health insurance, it will be in no small part the fault of this minority that won't give up the fight. Unfortunately, it seems that’s the idea.

About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
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