The saga of Obamacare is turning out to be the success story of the Obama presidency. What a ride it has been! The tale begins with President Obama in the throes of the worst economic collapse since the Great Depression deciding to put forth a plan for extending health coverage to some 30-40 million American citizens who lack medical insurance. Critics immediately slam the president for focusing on a radical new departure on health care rather than working exclusively on creating jobs and getting America out of a terrible downturn. In spite of these attacks, the president insists that his idea is a do-able one and that he can also simultaneously handle the dire recession. To achieve a victory for his plan, he works closely with Congress to devise an appropriate bill. The way forward is slow and aggravating. Finally, though, a proposal is agreed upon.
Next Obama must get it through a recalcitrant Congress, where every member of the Republican Party has declared they will oppose the bill. Early on he is able to win support for the bill in the democratically controlled House. But suddenly his veto-proof 60 vote majority in the Senate, on which the fate of his legislation vitally depends, is abruptly lost when a Republican wins Ted Kennedy's old seat in Massachusetts.
Obama is not sure what to do next. But his leadership colleagues in the Senate come through with a little used parliamentary maneuver to slip-slide the act through the Senate. The bill is now officially law. Still, even as he savors his accomplishment, Obama has to endure a sudden profusion of lawsuits from numerous Republican state attorney-generals who want the U.S. Supreme Court to declare the act unconstitutional. Obama is cognizant that he faces a conservative majority on the court which most observers predict will overturn his controversial program. But then, to the astonishment of the country, the Republican Chief Justice John Roberts upholds the bill, allowing it to pass judicial muster by a vote of 5-4.
Even then the fate of the legislation hangs in the balance. For, with the 2012 presidential election upcoming, a Republican still might win the White House and roll back Obama's newly-enacted medical coverage. Once again, in the face of significant electoral obstacles, though, the president triumphs and narrowly wins reelection. This guarantees that Obamacare will go forward. But this is not the end of the tale.
Today, over a dozen Republican-controlled states are refusing to set up the health care exchanges that are called for by the bill and are eschewing expanded Medicaid coverage which the legislation also provides for. Thus Obama's legislation remains alive, but in a somewhat stalled condition. Still, the miracle is that this fiercely debated, emotionally volatile, unprecedented piece of legislation affecting over one-tenth of the U.S. population has survived so many extraordinary difficulties over a four-year period. Its remarkable survival and the enormous impact it has on American society makes it Obama's greatest legacy.