By John Q. Hosedrinker 
During the pandemic, enhanced Obamacare subsidies, implemented through emergency legislation, made ACA plans more affordable for many Americans. These subsidies are set to expire at the end of the year, leading to premium increases for next year and contributing to the government shutdown due to Republican opposition to their extension. While a public option could have initially controlled prices, factors like increased healthcare usage, medicine costs, and the potential for healthier individuals leaving the marketplace are also driving up premiums. Had a public option been enacted, its popularity may have fueled greater support for a more comprehensive healthcare system like Medicare for All.
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Where Would We Be If Joe Lieberman Hadn’t Killed the Public Option? The government shutdown fight over Obamacare subsidies is a painful reminder of what the Democrats failed to accomplish 15 years ago, and it’s a question that deserves a lot of pondering. I find myself circling back to this topic often, and the role of Joe Lieberman, in particular, elicits a strong reaction, to put it mildly. He’s a name that comes up in discussions about missed opportunities, and the potential for a different reality.
Lieberman’s actions weren’t a failure; they were a calculated move, seemingly aligned with corporate interests. The public option, which initially seemed poised to pass, was ultimately derailed, and many believe this was a pivotal moment. Some see it as the beginning of the end for the Democratic majority’s mandate, triggering the disenchantment of its working-class base, and contributing to the rise of what we now know as MAGA. The repercussions of that moment still resonate today.
While Lieberman has passed on, the legislative failure of the public option, particularly in light of the proposed single-payer option, is a glaring omission. The Democrats did manage to pass the most progressive healthcare legislation in US history, a step forward that was still, arguably, a compromise. But the voters seemed to punish them for this, handing control of Congress back to the Republicans at the earliest opportunity, effectively stifling any further progress. This is the persistent narrative surrounding the Democrats: it’s all about what they *didn’t* accomplish, conveniently overlooking the decades of Republican obstruction that often lay the groundwork.
The reality, as some see it, is that Americans are drawn to the spectacle of political theater, and are less concerned with hard work and effective governance. This is where the Republican playbook truly shines: they are very flashy about their work by lying about what they are doing. This is how they win elections, not based on their performance, which is often counterproductive. If voters truly understood the difference between the two parties, the argument goes, Republicans would struggle to win elections. And, of course, the Democrats bear the brunt of the blame.
Of course, we need to acknowledge the nature of the situation and the forces at play. There are those who feel Lieberman, as a centrist, was always part of the problem. They feel that his actions helped the insurance industry, which has seen its profits explode since the implementation of the ACA. The point here is that businesses are primarily driven by profit, not public service, and the problems with healthcare in the United States stem from this. It’s a painful reminder that, regardless of the challenges, the Republicans were hardly a source of help.
Some believe the Tea Party movement should have served as a learning experience. The “free market” healthcare, in the views of some, may not be sustainable. It is difficult to provide both affordable and accessible healthcare for everyone while simultaneously providing massive profits to the insurance industry and its many layers of intermediaries. At its core, it’s a question of choosing corporate welfare. And the Democrats, for all their faults, did at least try.
The potential for a different outcome, had the public option been successfully implemented, is a compelling one. Many believe it would have been a game changer. The Democrats failed to truly explain it, which allowed the Republicans to dismantle it piece by piece. Today, some believe the focus should shift to a single-payer system. The Democrats have the opportunity to push for three pillars: healthcare, affordability (higher pay and lower housing costs), and fair elections (ranked choice). And without a public option, the ACA may never have survived the repeal attempts. But the deeper problem, according to some, is that the Democratic party is beholden to its donors.
The notion that Democrats squandered an opportunity is not lost on some. The current political climate, with a conservative-leaning Supreme Court, makes future progressive policies extremely challenging to pass. It’s a feeling of powerlessness, and that the planet will likely be harmed as a consequence. At the moment, the responsibility for the current government shutdown lies squarely with the Republicans.
One suggestion is the Democrats should lean into the idea that healthcare reform has been undermined for decades by Republicans. The single payer route is the only way forward. The problem many see with healthcare in the US, and the passage of the ACA, is that it didn’t go far enough. The idea of the ACA as a reworked version of RomneyCare is something to keep in mind, and a factor in considering how healthcare in America would look in an alternate reality.
Does anyone truly believe that a national public healthcare system had the votes to pass back then? If it did, it would have been put up for a vote. In truth, the Democrats have had politicians who have historically hindered progress. Criticizing the MAGA movement is easy, but introspection within their own party is a challenge. Acknowledging that the Democrats have failed to serve the people’s interests requires a significant commitment. We cannot keep repeating the same actions and expect positive change.