The long game of Obamacare

Many of you will remember the great debate that happened on the left as Obamacare worked its way through the Senate. Far too many people prioritized only one thing...the public option. Today I'm convinced that many of them never really knew what the public option was - the requirement that all state health care exchanges include at least one public insurance option - and instead equated it with a single payer system. President Obama has consistently been criticized on the left for failing to support single payer and that critique got equated with the simple idea of a public option on the exchanges.

But lets go back to 2008 and listen to what then-Senator Barack Obama said about single payer.



In addition to worrying about job losses during the great recession, President Obama talked about the fact that so many people rely on their employer for health insurance. Any move towards single payer would have to de-couple health insurance from employment.

As we move towards the unveiling of the state health care exchanges on October 1st, it is with that in mind that I read stories like this.

Home Depot Inc. said today that it would drop medical plans for part-time workers and direct them to the government-sponsored insurance websites scheduled to open next year as part of the health law...

Detroit and Chicago have proposed ending health plans for current or retired municipal workers, since they’ll be able to buy subsidized coverage through the health-care law...

Last week, Trader Joe’s Co., the closely held supermarket chain, said it would end health benefits next year for part-time workers. Employees will get a $500 payment and be sent to the public exchanges. With federal tax credits available there, most workers will get a better deal than the company could offer, Trader Joe’s said in a statement.

By offering other insurance options, “Obamacare has taken the moral imperative away for employers to continue offering coverage,” said Laszewski, the industry consultant. “The days of your father’s health insurance are over.”

Republicans will use this as an example of the havoc they envision coming from Obamacare and I've already seen too many liberals light their hair on fire about it as well. Whether or not employers will provide a subsidy in pay that is the equivalent of what they have been spending to purchase insurance is - of course - a concern.

But what I see in all of this is the extremely effective long game that is so typical of President Obama. He knew at the outset that if he championed the cause of single payer, he would never get it through Congress. And so instead he put in place a system that not only addresses significant immediate concerns, it will slowly but surely move us in the direction of decoupling health insurance from employment - opening up a whole range of possibilities.

Hang onto your hats, folks. This whole Obamacare thing is just getting started! It might be a bumpy ride. But I like where things are headed.