Obamacare Turns 12 With Record Enrollment, but Trouble Ahead
Health Care

Obamacare Turns 12 With Record Enrollment, but Trouble Ahead


When President Barack Obama signed the Affordable Care Act into law 12 years ago, Vice President Joe Biden was famously overheard telling his boss that the occasion was a “big f—ing deal.”

Today, despite a rocky start, the ACA boasts record enrollment, thanks in no small part to President Joe Biden’s effort to expand coverage in the first year of his administration amid the Covid-19 pandemic. To top it off, Republican efforts to overturn the law seem to have run out of gas, a situation noted by the Kaiser Family Foundation’s Larry Levitt, who wrote that there are “no meaningful political or legal threats to its existence for the first time since its passage.”

Biden celebrated the landmark legislation Wednesday. “Twelve years ago, I proudly stood beside President Barack Obama as he signed into law the most consequential expansion of health care in generations: the Affordable Care Act,” Biden said in a statement. “And because of my Administration’s efforts, including passing the landmark American Rescue Plan, we have lowered health care costs and made coverage more accessible than ever before — even amid a global pandemic.”

Obama noted the occasion, too, tweeting, “12 years ago today, I signed the Affordable Care Act into law. I’ve always believed that health care shouldn’t be a privilege for just a fortunate few, but a right for every American. Today, more than 30 million Americans have health coverage thanks to the Affordable Care Act.”

Obama also noted the important role the ACA has played during the Covid-19 crisis. “During the pandemic, the Affordable Care Act helped make vaccines and COVID-19 tests available for free, covered emergency hospitalizations, and prevented insurance companies from denying anyone coverage based on a pre-existing condition," he wrote.

Clouds on the horizon: One big reason that a record 15.5 million people signed up for health care through the ACA marketplaces in 2022 is that Democrats provided additional subsidies to reduce the cost of coverage and expanded the sign-up window via the $1.9 trillion American Rescue Plan, but those subsidies are temporary and scheduled to expire at the end of the year. The White House wants to make the subsidies permanent, but the Build Back Better bill that contained such a provision has stalled in Congress and is not expected to pass in anything like its most recent form.

Democrats reportedly plan to use the relatively popular ACA in their political campaigns this fall, highlighting the hostility to the program among Republicans — GOP Sen. Ron Johnson of Wisconsin recently cited overturning Obamacare as the kind of goal he’d like to see his party pursue — while claiming that a Republican victory would guarantee reduced support at best.

Republicans say they doubt the ACA will get much traction in the November election. Soaring gas prices, the war in Ukraine and worries about a recession are more likely to take center stage, leaving the 12-year old health care plan to keep chugging along quietly in the background.