Yes, Obama Won a Mandate

By Jonathan Cohn
The New Republic, November 7, 2012

I’ve waited more than two years to write this sentence: The Affordable Care Act is here to stay. It survived the Supreme Court and now it has survived the threat of a unified Republican government determined to repeal it. Implementation of the law will present huge challenges, but, for the first time in a long while, the administration and its allies can focus on those challenges rather than on rearguard political fights to keep the program alive.…

The reelection of President Obama and the failure of the Republicans to gain more than filibuster control of the Senate means that the Affordable Care Act (Obamacare, or ACA) will be fully implemented by 2014, as scheduled.

Although such complex legislation inevitably calls for legislative refinements, any significant efforts to expand the effectiveness of ACA would surely be blocked in the Republican-controlled House.

In the meantime, efforts on the state level to improve ACA will continue. Although small incremental steps are possible, it is unlikely that any model close to a true single payer system will be enacted within the states, even if the single payer label is used. The reason is that major enabling federal legislation would be required to construct a true stated-based single payer system, and the House still has its primary tool that it has wielded so effectively for the past two years: gridlock.

Although it seems like this might be a time to kick back and wait until the political climate improves, nothing could be further from the truth. The first step in advancing health care justice is to educate – inform the public on the facts.

We have two messages: 1) no matter how many tweaks are applied, ACA will not achieve health care justice – 30 million will remain uninsured, tens of millions underinsured, and health care costs will not be contained, and 2) there is a model that will cover absolutely everyone, provide access to high quality care, reduce financial barriers to care, and slow the increase in health care spending which would benefit us all – a single payer, improved Medicare for everyone.

We need to intensify our efforts to spread the word so that the people of our nation will be ready to support reform enthusiastically when the political climate becomes more favorable.