The Nation Obama Built

A POLITICO review of Barack Obama’s domestic policy legacy—and the changes he made while nobody was paying attention.

By Michael Grunwald
Vol. 3, No. 2, 1/06/2016

On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act, the 906-page health care reform law known as Obamacare. It was, as a live microphone caught Vice President Joe Biden exclaiming to his boss, a big deal, with Biden memorably inserting an extra word for emphasis—and for history—between “big” and “deal.”

Obamacare would cover millions of the uninsured, a giant step toward the Democratic dream of health care for all. It also included dozens of less prominent provisions to rein in the soaring cost and transform the dysfunctional delivery of American medicine. It was the kind of BFD that the most consequential presidencies are made of, even though it had squeaked through Congress without any Republican votes, and few Americans truly understood what was in it.

Even fewer Americans understood what was in the Health Care and Education Reconciliation Act, the 55-page addendum that officially finalized Obamacare. This was the strange legislative vehicle that Democrats had jerry-rigged to drag reform around a Republican filibuster. Its substance was mostly an afterthought—the New York Times ran a dutiful story on page A16 after it passed—but as Obama noted when he signed it the next week at Northern Virginia Community College, it included another BFD.

“What’s gotten overlooked amid all the hoopla, all the drama of last week, is what’s happened in education,” he said.

Yes, education. Tucked into the parliamentary maneuver that rescued his health care law was a similarly radical reform of the trillion-dollar student loan program. When Biden’s wife, Jill, a professor at Northern Virginia, introduced Obama that day, she called it “another historic piece of legislation.” The House Republican leader, John Boehner of Ohio, complained that “today, the president will sign not one, but two job-killing government takeovers.”

(More here.)