A historic deadline beckons Monday. Most Americans without health insurance must have started to apply for coverage by that deadline or face a financial penalty. It’s the first time that health insurance has been extended to virtually all Americans, and it marks a landmark in American cultural and economic history.
The Monday deadline also has a more prosaic meaning. It brings to an end a frantic period during which the Obama administration struggled to perfect its insurance-application process and then struggled to persuade Americans to use it. Neither struggle has been pretty. Nor has the political cacophony that has accompanied it.
But this deadline also offers Americans a health care breather. The next enrollment period doesn’t begin until November. It is a good time to take stock of what the health care debate has meant and what lessons can be learned from it. Here are some of them:
Vast social change is best accomplished in a bipartisan way.
From the start, this was the Obama administration’s principal error. It grew in part out of the Obama team’s determination to slam a health care bill through Congress at the time of the new president’s greatest appeal and power, but it, in fact, diminished Obama’s appeal and power even as it undermined the moral authority of the legislation.
The blame isn’t Obama’s alone. The Republicans swiftly and shrewdly identified this as the signature Obama initiative and were determined to deny him his triumph. But the burden of leadership — the burden of persuasion — was on the shoulders of the president, who swept into office covered in the same sort of fairy dust that sat 28 years earlier on the shoulders of Ronald Reagan, whose proposals were as anathema to Democrats in 1981 as Obama’s were to Republicans in 2009. Reagan, in admittedly different times, drew some Democratic support for his tax and budget cuts. The failure of Obama to do the same with a handful of moderate Republicans remains a stain on this legislation.