The Year In: Health Care.


When 2010 began, "death panels" were all the rage, Scott Brown was soon to gain Ted Kennedy's Senate seat, and health care reform looked to be on the ropes. Within a few months, however, reform, the culmination of decades of work by progressives, became law. But the debate didn't end when the Affordable Care Act was signed, and TAP covered it from almost every angle imaginable:

We celebrated the final passage of reform, because while the bill could have been better, we now have a foundation for a comprehensive and humane health-care system. TAP took a long look at what it will take to implement reform and detailed the role grassroots organizing played in the success of the Affordable Care Act. Finally, for all the skepticism about reform, we argued it will eliminate the anxiety and fear so many  live with because of the tenuousness of coverage.

Is there life left in the public option? Jacob Hacker, whose idea it was in the first place, said yes, and one state (Connecticut) is moving toward its own version. And although the ACA won't stop the rise of health care costs in the short term, it contains the seeds of meaningful long-term cost-control.

The debate has hardly ended; conservatives still seek "tort reform" that would hurt patients without saving money. Mostly, however, they are focused on the individual mandate as reform's political and legal weak spot. Just this month, a judge in Virginia ruled that the individual mandate portion of the bill is unconstitutional -- though the ruling  has already earned the scorn of both liberals and conservatives for its tenuous logic. As Adam Serwer argued, the individual mandate is good, constitutionally-sound policy. Still, as Paul Starr has shown, there is an alternative that could achieve the goal of a mandate without an actual mandate.

Health care reform actually held two promises for progressives. The first was affordable health care for (almost) all Americans; the second, less obvious promise, was to vindicate the role of government in our everyday lives. If successful, government-assured affordable health care would be an ideological defeat for conservatives who swear by a government is the problem approach to politics. Signing the bill was the first; step; the implementation process and the courts will make or break the actual success of health care reform.

-- Paul Waldman

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