By Susan Milligan
It seemed like old times Tuesday at the White House, with Joe Biden and Barack Obama touting the Affordable Care Act to an appreciative audience of Democratic lawmakers and health care advocates.
And former President Obama understands – really, no joke, folks – that Biden now has the top job as the current administration tries to build on the law signed 12 years ago.
“Thank you, Vice President Biden, Vice President Harris,” Obama said as he opened his remarks, eliciting chuckles and a dutiful salute from the man who was once Obama’s second-in-command and is now commander in chief.
“That was all set up,” Obama said, recovering, before re-addressing Biden as “my president” and lauding the efforts the current White House occupant is making to expand Obama’s signature law.
It was Obama’s first visit to the White House since he left in 2017, when Donald Trump – or “the former guy,” as Biden calls him – moved into 1600 Pennsylvania Ave.
And he had some direct and more nuanced advice for his successor’s successor: Pass what you can and improve it later on, once you get the framework in place. Understand that people will be wary of change at first but may well come around once they get used to a new policy. And always, always remember the microphone in the ornate East Room of the White House is live.
“Everybody who’s worked on this thing understood from the start that the Affordable Care Act isn’t perfect,” Obama said. His administration “had to make compromises” and “didn’t get everything we wanted.”
But “it is, to quote a famous American, ‘a pretty big deal,’” Obama said to laughter and a bowed Biden head.
The 44th president was referring to Biden’s awkward moment at the Obamacare bill signing in 2010, when the then-vice president leaned over to Obama and called the law “a big f—ing deal.” The expletive was caught on the microphone.
After teasing Biden about the changes at the White House – Secret Service agents now have to wear aviator glasses and the Navy mess is now an ice cream parlor, Obama joked, not to mention that “there’s a cat running around” – Obama said the grueling work it took to pass the health care law and defend it against myriad lawsuits and more than 70 efforts by Republicans in Congress to kill it was all worth it.
“I know how discouraged people can get with Washington. Everybody feels frustrated sometimes by what takes place in this town,” Obama said. “Progress feels way too slow. What the Affordable Care Act shows is that you are driven by the core idea that, together, we can improve the lives of this generation and the next.”
Biden, introducing himself as “Barack Obama’s vice president,” called Obamacare the “most consequential” piece of legislation since the establishment of Medicare and Medicaid in the 1960s. And just as with those programs, “we knew we had to keep strengthening this legislation.”
The administration announced Tuesday it is seeking a rules change that will fix the so-called “family glitch” in Obamacare. The law says people without “affordable” health care at work (meaning it costs less than 10% of the worker’s household income) can access a plan under Obamacare.
But the current rules do not take into account the cost of covering other members of the household. The rules change – which does not require congressional approval – would make the 10 percent threshold apply to the entire family.
A senior administration official said the new rule, which would take effect Jan. 1, will mean lower premiums for nearly 1 million Americans and coverage for 200,000 more who are now uninsured.
The law almost cost Obama reelection, the former president noted Tuesday, since it was unpopular and Republicans warned people they would be subject to inferior “socialized” medicine. It also contributed to a massive loss of Democratic seats in Congress that fall – a “shellacking,” as Obama called it at the time.
Since then, the law has become much more popular. Ongoing polling by the Kaiser Family Foundation shows that as recently as July 2014, 37% of people approved of the law and 53% disapproved of it. Last month, those numbers were virtually inverted, with 55% of Americans supporting the law and 42% disliking it.
Republicans have made noises about trying again to undo the law, should they take control of both chambers of Congress and the White House in 2024. Sen. Ron Johnson, Wisconsin Republican up for re-election this fall, told Axios on Monday that the GOP should repeal and replace the law if they accomplish that series of party control flips.
Democrats face a daunting political environment in this fall’s midterms, with many in their party retiring from office and others facing strong challenges from GOP candidates.
Asked Tuesday by a White House reporter what Democrats could do to improve their chances in November, Obama said, “We’ve got a story to tell. We’ve just got to tell it.”
After Obamacare passed, the number of non-elderly, uninsured Americans fell from 48 million in 2010 to 28 million in 2016, the Department of Health and Human Services reported. But the number rose back up to 30 million by 2020. Trump, who opposed the law, cut tens of millions of dollars in funding for “navigators,” people hired to help Americans sign up for coverage, and made no real effort to promote the plans during the sign-up season.
In the last sign-up period, from November 2021 to mid-January of this year, a record 13.6 million Americans signed up for coverage under Obamacare plans.
When the new rules go into effect, “working families in America will get the help they need to afford full family coverage,” Biden said at the Tuesday event. He urged more states to join the 38 states that have expanded Medicaid under the health care law.
Then he and Obama went on to work the room – just like they did when Obama had the top job. “Barack, I’m going to remind you,” Biden said as the crowd clamored to greet them. “It’s a hot mic.”