Photo: The Canadian Press
Former President Barack Obama listens as Vice President Kamala Harris speaks about the Affordable Care Act, in the East Room of the White House in Washington, Tuesday, April 5, 2022. (AP Photo/Carolyn Kaster)
With hugs, laughter and good-natured banter, Barack Obama returned to the White House for the first time in more than five years Tuesday to savor the 12th anniversary of his landmark health care law and give a boost to President Joe Biden’s efforts to expand that.
The Affordable Care Act has survived repeated repeal attempts by Republicans.
Biden, who was Obama’s No. 2 when “Obamacare” was signed into law in March 2010, wants to extend the law’s reach even beyond the current millions. He gave all the credit for the original law to the former president.
“It’s thanks to you,” Biden said after politely introducing himself as Obama’s vice president. Biden said the law “shows that hope leads to change,” a pun on Obama’s “hope and change” campaign slogan.
Obama was last in the White House on Jan. 20, 2017, when he left to escort Donald Trump, the successor bent on repealing the law, to Capitol Hill for his inauguration.
“It’s good to be back in the White House. It’s been a while,” he said after Vice President Kamala Harris introduced him in the East Room. Obama began by referring to Biden as “vice president” before acknowledging that it was a “prepared” joke and hugging his No. 2 ex.
Obama said he and Biden accomplished “a lot” in their eight years, but “nothing made me prouder than providing better health care and more protections to millions of people across the country.”
“The ACA was an example of why you run for office in the first place,” Obama said, calling it the “highlight of my time here.”
Biden called the Affordable Care Act the most important piece of legislation since Medicare and Medicaid were created in 1965, insisting it must be expanded to more people.
“We can do this. We should do this. We have to do this,” Biden said. He said the law has been called by many names, “but Obamacare is the right one.”
Biden and Obama marked the 12th anniversary of the law, which in 2010 the then vice president memorably whispered to Obama was a “big (expletive) deal,” words captured on an open mic.
At Tuesday’s event, Biden signed an executive order closing a “family loophole” in the implementation of the 2010 law that his administration believes will help an additional 200,000 people get affordable coverage.
Before signing the order, Biden jokingly warned Obama. “Let me remind you that it is an attractive microphone.”
Obama roused the crowd with some deadpan jokes about how things had changed in the White House under Biden, building on the current occupant’s affinity for sunglasses and ice cream and his love of pets.
He joked that Secret Service agents now have to wear aviator sunglasses, the clutter of the White House has been replaced with a Baskin-Robbins, and “there’s a cat running around.”
“I guarantee you Bo and Sunny would have been very unhappy about that,” Obama added, referring to his family’s dogs.
As for “Obamacare,” the law’s staying power has been bolstered by three Supreme Court victories and the late Sen. John McCain’s emphatic no vote that halted then-President Trump’s efforts to overturn and replace it.
The law was so problematic in 2010 that Democrats rarely invoked it as they headed into a midterm election that turned out to be, in Obama’s own words, a “bombing.” Now, Democrats are hoping the political equation works in their favor, and that a focus on law enforcement can help them avoid a meltdown at the polls this November.
Harris, in her remarks, called on Congress to allow Medicare to negotiate prescription drug prices and provide permanent Affordable Care Act subsidies that were included in Biden’s pandemic relief bill. Harris also called out 12 states that have not expanded Medicaid eligibility.
Obama referred to the health care law as a “starting house” that Americans can build on, gradually reducing the proportion of the 9% of the population that remains uninsured. The rate was nearly 15% in 2013, before the coverage provisions of the law took effect. Between Medicaid’s expansion of the health law and its health insurance marketplaces, it’s estimated that more than 30 million people now get coverage.
Biden opened up health insurance markets to anyone looking for coverage during the COVID-19 pandemic, and his coronavirus relief bill provided a significant, albeit temporary, boost in financial assistance. The result was a record 14.5 million people signing up for private subsidized coverage.
People affected by the “family ruling” are dependents of workers who have an employer offer of coverage that the government interprets as affordable. As a general rule, people with affordable employer coverage are not eligible for taxpayer-subsidized ACA plans.
But the problem with the current interpretation is that affordability is determined by the cost of employee-only coverage and not more expensive family policies. Workers who can pay their own share may not be able to cover premiums for the entire family. So the family is out of ACA coverage.
A Biden administration regulation addressing the issue recently passed the White House review. The original policy was intended to prevent people with employer coverage from entering markets subsidized by the health law, but advocates say it has turned out to be too restrictive.
There are also more fundamental issues for the two presidents to consider, both politically and politically.
Unless Democrats in Congress finally coalesce around a version of Biden’s social legislation, his enhanced financial assistance for millions of people who buy ACA plans will expire at the end of this year. A return to higher premiums would likely cause an increase in the number of uninsured, a problem for them and a political embarrassment for Democrats committed to expanding coverage.
Biden’s legislation, which passed the House but failed in the Senate, also includes a mechanism to provide coverage for up to 4 million low-income uninsured adults in states that have rejected the health law’s Medicaid expansion. It would deliver on Biden’s campaign promise to build on existing government programs to move the US closer to coverage for all.