CHARLESTON, W.Va. -- Obamacare was enacted three and a half years ago, but only now do many people want to know what's in the law.
The Affordable Care Act (its other name) is very complicated, but even the basics, like ending insurance company pre-existing condition limitations, inducing most Americans, even if they are healthy, to have medical insurance, and financially helping those who can't afford the premiums, are still often misinterpreted or ignored.
This complexity has also led many Republicans, who previously complained of "death panels" and "a government takeover of health care," to discourage states from participating in Medicaid expansion or crafting exchanges, to frighten individuals, and to intimidate potentially helpful organizations, with their ultimate goals seemingly being to disrupt and confuse.
Now, they're threatening to shutdown the government or decline to raise the debt ceiling unless all Obamacare funding is stopped, apparently hoping that the resulting turmoil will benefit them politically in 2014, even though it may keep many of the eligible uninsured from getting coverage and improving their lives.
I generally try to avoid partisanship, but this situation demands straight talk. With their ongoing negative comments and actions concerning the politics and process of Obamacare, the Republicans seem to have amnesia about what happened with the 2003 Medicare Part D prescription drug bill.
They conveniently don't remember that this legislative centerpiece for George W. Bush became law with little, if any, Democratic support under quite unusual circumstances.
Specifically, passage in the House of Representatives involved a rule-violating three-hour late night vote that included some actions that were akin to outright bribery on the House floor. In the Senate, the Republicans used the budget reconciliation process (which they criticized loudly during action on Obamacare) to pass the bill with just 54 votes and then excluded the duly elected Democratic members of the conference committee from deliberations.
In 2005 and 2006, lest we forget, the initial efforts to implement Medicare Part D were downright messy. Trying to educate millions of computer-illiterate seniors about their often confusing choices as they created or changed their prescription drug coverage was a proverbial "train wreck".