The Democratic response to the murder of UnitedHealthcare CEO Brian Thompson raises questions about the scope and significance of the federal healthcare reform legislation they passed without any Republican votes under former President Barack Obama.
President Joe Biden, then the vice president, famously called the enactment of the Affordable Care Act a “big f***ing deal” at the 2010 signing ceremony. But when he sought the Democratic presidential nomination himself 10 years later, he was the only top-tier candidate running on Obamacare rather than other more government-centric healthcare plans.
Biden won the nomination, defeating several proponents of Medicare for All, including Vice President Kamala Harris. But most Democrats were speaking as if Obamacare had never passed roughly a decade later, even as they defended the law from Republican repeal attempts. “The reality is right now, we don’t have a healthcare system,” Tulsi Gabbard, then a Democratic congresswoman and presidential candidate, said in 2019. “Nobody can defend the dysfunctionality of the current system,” Sen. Bernie Sanders (I-VT) concurred at the time.
Democrats have sounded a similar note since Thompson’s slaying. “The visceral response from people across this country who feel cheated, ripped off, and threatened by the vile practices of their insurance companies should be a warning to everyone in the healthcare system,” Sen. Elizabeth Warren (D-MA) told HuffPost when asked about jubilant social media posts celebrating his death. Some have expressed sympathy for shooting suspect Luigi Mangione.
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“The outpouring afterward has not surprised me,” Rep. Ro Khanna (D-CA) told ABC News. “Look, I as a congressperson had UnitedHealthcare deny a prescription for a nasal $100 pump spray, and I couldn’t get them to reverse this. So imagine what ordinary people are dealing with the biggest denial comes when it’s cancer treatment. I mean, people are getting denied on cancer treatment.”
“I think this collective American experience, which is so twisted to have in the wealthiest nation in the world, all of that pain that people have experienced is being concentrated on this event,” Rep. Alexandria Ocasio-Cortez (D-NY) told a reporter in response to Thompson’s death. She later added, “I think for anyone who is confused or shocked or appalled, they need to understand that people interpret and feel and experience denied claims as an act of violence against them.”
“My view is very simple: Why can’t we have a rule that if a doctor prescribes something and if Medicare — traditional Medicare — is going to cover it, then private insurance companies should be forced to cover it?” Khanna said on ABC. “I mean, it’s absurd in this country what’s going on.”
Warren, Khanna, and Ocasio-Cortez all stressed that they did not believe violence was justified.
But Obamacare has been the law of the land for nearly 15 years and progressives still view the healthcare system as highly unjust. Many, perhaps most, elected Democrats now prefer expanding Medicare to Obamacare’s approach of mandating, subsidizing, and regulating private health insurance as a way to expand coverage. Earlier versions of the legislation also included a government-run public option that was stripped out in the Senate. Medicaid expansion was another key component of Obamacare.
The progressive fallout over the slain healthcare CEO comes just weeks after a presidential election in which Harris abandoned her past advocacy of Medicare for All, of which she was once a Senate co-sponsor, and a plan she proposed during her unsuccessful 2019 campaign for the Democratic nomination. The latter was similar to what Khanna described above.
“We will allow private insurers to offer Medicare plans as part of this system that adhere to strict Medicare requirements on costs and benefits,” Harris said at the time. “Medicare will set the rules of the road for these plans, including price and quality, and private insurance companies will play by those rules, not the other way around.” This year, she wanted to avoid criticism that she would take away private health insurance.
Voters generally criticize the high costs and unequal access in the current healthcare system while tending to give high marks to their own coverage. They respond poorly to policy changes that disrupt their existing healthcare arrangement, which is why Obamacare was initially unpopular and the Clinton administration’s healthcare plan failed to pass. Both bills cost Democrats control of the House of Representatives, 16 years apart from each other.
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Obamacare rebounded when Republican attempts to repeal it began to be disruptive of existing coverage arrangements. Republicans also never coalesced around an Obamacare replacement plan. Republicans largely abandoned Obamacare repeal during President-elect Donald Trump’s first term, though they did successfully gut one of its least popular provisions, the individual mandate. Trump admitted he had only a “concept of a plan” to improve healthcare in his debate with Harris.
Nevertheless, problems in the healthcare system have persisted. The most liberal Democrats prefer solutions to the left of Obamacare, which borrowed concepts from Mitt Romney’s Massachusetts healthcare plan when he was the commonwealth’s Republican governor. Many of them are also extremely angry at health insurance companies, as recent events indicate.
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