During his daily briefing on Tuesday, White House press secretary Sean Spicer offered a particularly pessimistic assessment of how Obamacare (né the Affordable Care Act) came into existence.
Standing beside two stacks of paper, one representing a new proposal from House Republicans and the other a copy of the ACA, Spicer promised a smoother and more inclusive process for the Republican bill than the law it hoped to replace.
“One of the things that’s important to understand about this process, that’s very different from when the Democrats did it,” Spicer said. “You recall then-Speaker [Nancy] Pelosi said, ‘You’re going to have to read the bill to know what’s in it?’ I think there’s a big difference. This is the bill. It’s right here.”
He noted that the bill was already online. “Everybody can read it, and it’s going to go through what they call ‘regular order,’ ” he said. “We’re not jamming this down anybody’s throat. It’s going to go through a committee process. All parties involved, all representatives in the House will be able to have input into it. I think that’s the way to conduct this process, is to do it to allow people to watch the process happen in the committees, allow members of Congress to have their input in it, to make amendments, to see that we get the best bill that achieves the goal for the American people. When it was done the last time, it was jammed down people’s throats. And look what happened.”
Spicer’s description of the process that led to the Affordable Care Act aligns strongly with conservative interpretations of its genesis over the past seven years. It doesn’t align particularly well with what actually happened, however.
It was almost exactly eight years ago that President Barack Obama began the process that would lead to the signing of the bill in March 2010. On March 5, 2009, Obama held a summit with 150 health-care experts to discuss reforming the health-care system. “The status quo is the one option that is not on the table,” he said then. “And those who seek to block any reform at any cost will not prevail this time around” — a reference to the blockades that health-care reform met with during the Clinton administration. As it turns out, he was right, but those who sought to hinder his reforms came very, very close.
By July, a draft bill — all 1,000 pages of it — was being passed around the Hill. Democratic leaders scheduled a lengthy seminar to inform lawmakers on the details of the legislation.
When members of Congress went to their districts for the August break, everything erupted. Over the month, lawmakers held town hall meetings that were swamped with anti-reform activists. This was the formative moment for the tea party movement, as negative depictions of the health-care proposal galvanized opposition.
In response, the group Organizing for America launched a bus tour to promote the reform effort. This was “an acknowledgment that they’re in trouble,” the head of the conservative activist group FreedomWorks told The Washington Post at the time. “The grass-roots anger over the spending and the size of the health-care grab by Obama is real,” he said of his organization’s efforts. He was correct.
The reform bill that would first pass the House was introduced in late October. Debate began on the House floor at 2 p.m. on Nov. 7, and the bill passed nine hours later. (The Republicans had put forward their own reform proposal, which didn’t stand much of a chance of passing in Democratic-controlled Washington. What’s more, analysis of the Republican proposal by the Congressional Budget Office was a disaster.)
The bill that became the law, though, was passed in the Senate. In the fall, the chamber — under filibuster-proof control from the Democratic caucus — took unrelated legislation from the House and rewrote it, because budget-related legislation must originate on the other side of the Capitol. By this point, the debate over health-care reform was deeply polarized on partisan lines and, after a 25-day debate on the Senate floor, the legislation passed on Christmas Eve without a single Republican vote.
One of the Democratic votes came from Sen. Paul Kirk (Mass.), who was appointed to fill the seat left empty by the death of Edward M. Kennedy in August. In January, the state held a special election to replace him and — in a stunning shift — a Republican, Scott Brown, won. All of a sudden, the Democrats didn’t have the ability to break a filibuster, and the dynamics of the legislation shifted.
Brown was sworn in about a week after Obama’s 2010 State of the Union address, which focused heavily on the health-care fight. (“Here’s what I ask Congress, though: Don’t walk away from reform,” he said. “Not now. Not when we are so close. Let us find a way to come together and finish the job for the American people.”) A few weeks later, Obama held a seven-hour summit with congressional leaders calling for the final passage of a reform bill.
It was after all of this, more than a year after the first summit Obama held, that Pelosi made her comment about passing the bill to see what was in it. She made the remark during a speech at the 2010 Legislative Conference for National Association of Counties.
“We have to pass the bill so that you can find out what is in it,” she said, in short. In broader context, she said:
You’ve heard about the controversies within the bill, the process about the bill, one or the other. But I don’t know if you have heard that it is legislation for the future, not just about health care for America, but about a healthier America, where preventive care is not something that you have to pay a deductible for or out of pocket. Prevention, prevention, prevention — it’s about diet, not diabetes. It’s going to be very, very exciting. But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy.
A more charitable reading: You’ll see how effective the bill is — and how wrong the opposition was — once it’s law. At a lunch meeting in 2012, she explained the comment in more detail.
“In the fall of , the outside groups … were saying ‘it’s about abortion,’ which it never was,” she said, according to The Post’s Jonathan Capehart. “ ‘It’s about ‘death panels,’ ’’ which it never was. ‘It’s about a job-killer,’ which it creates 4 million [jobs]. ‘It’s about increasing the deficit’; well, the main reason to pass it was to decrease the deficit.”
But the line stuck, creating the impression that Pelosi was stating that the bill should be passed without anyone reading or considering it.
The loss of the Kennedy seat did mean that the politics were going to get funky. Because changes to the Senate bill would need to be approved again by the Senate — and would be subject to filibuster — House Democratic leaders decided to pass the Senate measure as it was. To guarantee support from its caucus, the leaders needed to make some amendments, though. So they seized upon the idea of using the budget reconciliation process to make those changes — a process that meant changes had to be focused on particular budget-related issues but that also meant the Senate vote couldn’t be subject to filibuster.
That’s what they did, passing both measures without any Republican votes. Obama signed the main bill into law on March 23. The first bill to repeal Obamacare was introduced in the Senate that same day.
In addition to his ungenerous (though not uncommon) read on Pelosi’s remarks, Spicer’s comment that the health-care bill was “jammed down people’s throats” appears to focus on the process by which it was passed. It’s not the case, though, that the reform effort lacked public consideration and input of the sort that Spicer is championing, as the above timeline makes clear. In fact, public outcry significantly reshaped the process in the summer of 2009.
It’s worth noting, too, how Republicans have proposed moving forward on the replacement bill. Last week, the Capitol was tied up in knots as lawmakers sought to locate a copy of the bill that was being developed. The legislation, introduced on March 7, will go to congressional committees this week, and lawmakers are prepared to move the bill forward without waiting for analysis of the effects from the Congressional Budget Office. Republicans hope to hold the vote by April 7.
The problem that the Democrats encountered, the problem that inspired them to “jam the bill down Republicans’ throats,” was largely that efforts to create compromise legislation were impossible once the idea of health-care reform became anathema to Republican voters. Remember: That was the impetus for the use of the reconciliation process in 2010. The idea of repealing Obamacare is already unacceptable to most Democrats, of course, so suggesting that Republican leaders might lead an open process that results in compromise over the next month is already probably too optimistic.
They have a way around that, though. Republicans hope to use the reconciliation process, eliminating the need for Democratic votes to overcome a filibuster.