It's the Same F.....ing Law

It was an obscure Congressional Hearing, and the witness had been on the stand for a long time.  He was being grilled by hostile Republicans, who predictably were attacking the proposed Affordable Care Act at every turn.  The witness was an insurance expert, who had been instrumental in getting the Health Care Act passed in Massachusetts, nicknamed RomneyCare by friends and foes alike.

The witness carefully answered the hostile questions, that often implied the ACA was a "socialist plot".

At the time, the "single payor" optionn was still in the ACA, which meant insurance companies would have to compete with the United States government in providing their "products" to the public.  This would be a disaster for them, since they would have to cut profits dramatically and would have to actually have to compete.

In Massachusetts there was no single payor.  The state did not offer insurance, but there were insurance exchanges, and most other major features of the ACA.  

Finally, after discussing the single payor option, the witness blurted out, "It's the same f......Bill".  

Right there the deal was sealed.  Without the single payor option, the ACA was and is virtually identical to the Massachusetts Bill.  And its partial author at least was Governor Romney, whose idea was the insurance exchanges.

Romney was planning then, it was 2010 , to craft his run for President around  RomneyCare, that after a rough beginning, was beginning to get traction.  

But, as we all know, after the brutal primaries, where conservatives dominated, Romney had to actually run against his greatest single governmental accomplishment.  And he lost his bid for the Presidency, declaring that he would repeal "Obamacare" that was essentially the "same f....ing bill" he had successfully passed in Massachusetts.

Today, as the Republicans predictably continue their insane assault on the ACA, even going so far as shutting down the government to repeal the law, we see the same problems implementing the law as occurrred in Massachusetts.  The young and healthy wait until the individual mandate, penalty, is imminent, before they rush to enroll.  But once this happens, the law works, health care is spread to millions more people.  

In the end, 97% of Massachusetts citizens are enrolled in health care, healthy statistics are increasing, employment is higher than in the U.S., the economy is doing better; in all, the "same f....ing bill" is working.

And it will in the United  States also, particularly in states that decided to adopt the law and embrace it.   Their exchanges are working, and the sign up is taking place.

It will take at least five years before we will be able to assess the ACA as in Massachusetts.  But, we do have a laboratory if you will in Massachusetts and the "same f....ing bill, works".  

With the single payor option, it will really work to bring health care costs down!   That is the next big reform we need to put back into the ACA.