Roosevelt and the Affordable Care Act

With six months to go before the main elements of the Affordable Care Act kick in, it's no surprise that the Act's opponents, who have already spent an estimated $400 million on negative television ads, are making a final assault.
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With six months to go before the main elements of the Affordable Care Act kick in, it's no surprise that the Act's opponents, who have already spent an estimated $400 million on negative television ads, are making a final assault. It is now or never for them.

The surprise is that President Obama has given new life to the opponents of Affordable Care by the timidity with which his administration has announced that it will wait until 2015 before requiring employers with more than 50 full-time workers to offer health care coverage or pay a fine.

The first news of the employer-mandate delay came in a blog post by the assistant secretary for tax policy at the Treasury Department. It was as if the administration wanted nobody to notice what it was doing, when, in fact, it had no reason to feel defensive. According to Mark Duggan of the Wharton Business School, the employer-mandate delay will affect just 1 percent of the nation's workers and a fraction of the 5.7 million firms in the United States (most big firms already offer health insurance).

At this stage of the game, President Obama should be optimistic about the future of the Affordable Care Act. History is on his side. He can take heart from how President Franklin Roosevelt managed the fight over Social Security on the eve of its implementation.

After Congress passed the Social Security Act in 1935, its opponents launched a tax-no-prisoners attack against it. With the pay roll tax for Social Security due to begin on January 1, 1937, they used the 1936 presidential election to try to persuade the country Social Security was a liability.

In the spirit of Republican senator Pat Roberts of Kansas, who has charged the Affordable Care Act with failing to protect "the all-important relationship between you and your doctor," Alfred Landon, the Republican presidential nominee and Kansas governor, called Social Security a "cruel hoax" that "involves prying into the personal records of 26 million people."

The attack by the business community against Social Security was equally vicious, as the New Deal historian Arthur Schlesinger Jr. has pointed out. In the weeks before the election, signs went up in plants across the country telling workers, "You're sentenced to a weekly pay reduction for all your working life. You'll have to serve that sentence unless you help reverse it November 3."

In their pay envelopes workers found the following message: "Effective January, 1937, we are compelled by a Roosevelt 'New Deal' law to make a 1 percent deduction from your wages and turn it over to the government. Finally, this may go as high as 4 percent. You might get this money back... but only if Congress decides to make the appropriation for this purpose."

The message made no mention of the employers' contribution to old-age and unemployment insurance, just as today's critics of the Affordable Care Act don't talk about how it will allow individuals with a pre-existing health condition to pay the same insurance rates as healthy people.

The attacks on Social Security angered Roosevelt, and in an October 31 address at Madison Square Garden on the eve of the election, he went directly after his critics. "Every message in a pay envelope, even if it is the truth, is a command to vote according to the will of the employer," Roosevelt declared. "But this propaganda is worse -- it is deceit."

FDR went on to spell out the ways in which Social Security would benefit workers plus require a significant contribution from their employers. Then he took on the implication that Social Security's reserves might be "stolen by some future Congress."

"They attack the integrity and honor of American government itself," Roosevelt observed of Social Security's foes. "Let them emigrate and try their lot under some foreign flag in which they have more confidence," he thundered.

The speech was Roosevelt at his most persuasive. Voters thought so, too. FDR won the 1936 election in a landslide, carrying all but two states, Maine and Vermont.

The kind of political anger Roosevelt showed at Madison Square Garden does not come easily to President Obama, but he does not have to be a second FDR in order to be persuasive about the Affordable Care Act.

Personal stories will do just fine, starting with what it already has meant for millions of families to have their insurer required to offer them free preventive services, such as flu shots and mammograms.

Nicolaus Mills is professor of American Studies at Sarah Lawrence College and author of 'Winning the Peace: The Marshall Plan and America's Coming of Age as a Superpower.'

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