I was recently on an American Political Science Association panel exploring the politics of health reform. Many of us -- myself certainly included -- were a little down. We lamented the imprudent back-loading of the Affordable Care Act. It didn't provide enough immediate and tangible benefit to visibly change people's lives in time for the midterm elections. Many of the most important benefits -- affordability credits, health insurance exchanges -- don't kick in until 2014.
That's true. But what if health reform really is improving people's lives, only the public isn't paying attention? What if, in our sour public mood engendered by the bad economy, we are ignoring how health reform is already helping some of our own friends and neighbors who most need help?
I thought about this today when my wife handed me a letter from my university's health plan. In dry bureaucratic prose, it explained how the plan would be changing to come into compliance with health reform. Starting next year, my daughters will be covered on our insurance until age 26. We will have no lifetime maximum limit on medical expenses. In related changes, mental health and substance abuse coverage has been improved. Children will not be denied coverage due to preexisting conditions. These are critical issues for anyone with a costly illness or who cares for an injured, disabled, or chronically-ill child, parent, or spouse.
I don't know about your situation. My own life has become tangibly more secure because of health reform. I'm relieved that my kids won't go uninsured as they navigate their late teens and early-20s. Because I work for a large employer, my family already enjoyed significant protections against insurance company rescissions and other practices that harm people with chronic illnesses. Now millions of other Americans who buy insurance on their own or who work for a small business will enjoy the same protections that we do. I'm happy to see improved regulations to deter our insurer from denying appropriate claims or dropping people from coverage.
I'm steadily employed. My family is basically healthy. Yet I know (among other things, from my perch as a university dean and participant in university governance) that not everyone is so lucky. Across our diverse workforce, there are single moms with autistic or disabled kids who mop floors and empty trash cans for their medical benefits. There are junior faculty and graduate students in the same situation. All over Chicago, tens of thousands of parents face similar predicaments. Only they aren't lucky enough to work for a large university with a multi-billion-dollar endowment.
Health reform has accomplished real things to help many of these families dealing with chronic illnesses and other private worries. It's helping young adults who need health insurance while they finish school or find their first steady job. Much of that help is arriving now--not in 2012 or 2014. On the ground, in millions of lives, health reform was worth the great political capital the President and congressional Democrats expended to finally pull it through.
These accomplishments aren't always dramatic or sweeping. They will show up quietly in millions of lives, not always attracting the public attention they deserve. Republicans have obvious incentives to minimize these accomplishments, to depict health reform as just more taxes and bureaucracy. Such appeals are momentarily effective. The public is not especially ready to notice what health reform is accomplishing. People are in a foul mood. The terrible economy infects everyone's sense of the possibilities for positive reform and social change.
Just by holding office for 19 incredibly eventful months, President Obama has started to "own" that bad economy, even though Republicans and moderate Democrats have thwarted many efforts to address recession more effectively.
Liberals, particularly young HuffPost readers, are becoming a bit jaded and demoralized by the sclerotic mechanisms of the United States Senate, which so facilitate obstruction on stimulus, climate change, and more.
In this hard political and economic time, Democrats should note that we've accomplished some wonderful things. Voters may not be paying as much attention now. As health reform becomes a part of the fabric of American life, people will notice, and will embrace it.
As the midterms approach, we should hold our heads high and run on our record. We should be proud of what we've accomplished. We can accomplish much more if we actually turn out.