“Bidencare” is a really big thing

In 2010, during the signing Assume affordable careAlso known as ObamacareJoe Biden, the vice president at the time, was accidentally recorded telling the president Barack Obama That the bill was a “big deal.” Well, actually, there was another word in the middle. Anyway, Biden was right.

And among one of his great unsung accomplishments (it’s surprising how many Americans believe that an unusually productive president didn’t accomplish much) President Biden Obamacare has become an even bigger business, improving the lives of millions of Americans.

As you may have noticed, many Americans finally seem to be paying attention, Biden has been putting up some pretty good numbers lately. Defying widespread predictions of a recession, economic growth continues to pick up, while unemployment is near its lowest level in 50 years. Inflation, especially using the Fed’s preferred measure, has moved closer to the Fed’s target. The stock market is constantly reaching new highs.

Oh and Murders are downAnd violent crime in general is likely to hit another 50-year low.

Biden deserves some political reward for this good news, given that Donald Trump And many members of his party predicted economic and social disaster if he were elected, and Republicans in general still talk as if the United States is suffering from high inflation and rampant crime. . (Trump, of course, is dismissing the good employment numbers as bogus. Wait until you hear about the drop in crime.)

The extent to which the good news on this front can be attributed to Biden’s policies is less clear. Presidents certainly don’t control the stock market. In general, they have less influence on the economy than many believe; He will give Biden some credit for the strength of the economy, which was driven by his spending policies, but the rapid disinflation of 2023 mainly reflects a nation trying to recover from the lingering disruptions of the Covid pandemic. Perhaps the same is true of the decline in violent crime.

However, one area where presidents make a big difference is healthcare. Obamacare, that should really be called PelosicareGiven that Nancy Pelosi (Who isn’t, regardless of what Trump thinks, someone like Nikki Haley) played a key role in getting it passed in Congress, which when it passed was a big step forward in health insurance coverage. It came into full force in 2014.

Trump unsuccessfully tried to repeal Obamacare in 2017, and the backlash from that effort helped Democrats take control of the House the following year. However, Trump was able to make some cuts to the program, for example by cutting funding for “navigators” who help people register.

That erosion has now been decisively reversed. The Biden administration just announced that 21 million people have signed up for coverage through the ACA health insurance marketplaces., compared to about 12 million on the eve of the pandemic. The United States still does not have the universal coverage standard of other wealthy nations, but some states, including Massachusetts and New YorkThey have come close.

And this gain, unlike the other good things that are happening, depends entirely on Biden, who restored help to those seeking health coverage and reformed a key aspect of the system.

Obamacare is not easy. Many health economists I know would have favored something like Medicare for All, if it had been politically possible. But it wasn’t and isn’t, so what we have in its place is of some sort Rube Goldberg, a combination of devices designed to expand access to healthcare with minimal disruption to existing systems. Those markets, where insurers are prohibited from discriminating against people with pre-existing conditions and buyers receive subsidies to help them pay premiums, are a key part of the system.

It’s not an ideal method, but it’s better than nothing. However, the markets were originally underfunded: subsidies were very low, so many people still had difficulty paying insurance premiums, and there was also a cap, with subsidies available only to individuals up to 400 percent of the poverty line.

Biden, as part of the Inflation Reduction Act of 2022, largely addressed these problems by lowering maximum premium payments (net of subsidies) and eliminating the 400 percent gap. The result is to make health insurance coverage significantly more affordable, especially for middle-income Americans who previously earned too much to qualify for subsidies. This has led to an increase in registrations in the market.

I don’t know if healthcare will be a major issue in the 2024 election. But it should be.

Biden has made health insurance coverage more accessible and affordable for millions of Americans.

however, If Trump wins, he will try again to end Obamacare; He has said and this time he can achieve it well. He promises to replace it with something “much better.” I guess this depends on your definition of better: In 2017, the Congressional Budget Office estimated that Trump’s health plan would increase the number of uninsured people by 32 million over a decade; That number would probably be higher today.

Another reminder of what’s at stake this year.