Exactly five years ago today, the White House hosted a signing ceremony in the East Room for one of the most important policy breakthroughs in a generation. Policymakers from both parties have talked about providing health security for all of the nation's families for roughly a century, but on March 23, 2010, officials gathered not just to talk but to celebrate action.
Vice President Biden introduced President Obama to the audience and, in comments that weren't intended for the public's ears, said to the president off-mic, "This is a big f***ing deal." Five years later, there's little doubt that Biden was entirely correct.
If you'd told me five years ago that on March 23, 2015, the Affordable Care Act would exceed expectations on every possible metric, including reducing the nation's uninsured rate by a third, I'd say "Obamacare" would look like a great success. And fortunately for the country, that's exactly what's happened.
Anniversaries are a good time to pause, reflect, and take stock, and when it comes to health care reform, objective observers are going to find it easy on the ACA's fifth anniversary to appreciate the law's triumphs. But it's also a good time to take a moment to acknowledge those who told Americans exactly what to expect from the Affordable Care Act -- and who got the story backwards.
Failed Prediction #1: Americans won't enroll in the ACA
In 2009 and 2010, it was widely assumed among Republicans that Democrats had fundamentally miscalculated public demand and consumers would show no real interest in signing up for coverage through the Affordable Care Act. Indeed, among some on the right, this was a foregone conclusion -- Americans wouldn't trust "Obamacare." We now know, of course, that the opposite is true and that millions of families have eagerly signed up for benefits through the ACA.
Failed Prediction #2: The ACA won't meet its enrollment goals
OK, so maybe some consumers would enroll, Republicans eventually said, but the ACA would inevitably lose the numbers game when the enrollment projections proved overly ambitious. In reality, both this year and last year, enrollment totals exceeded the Obama administration's preliminary projections.
Failed Prediction #3: Insurers will want no part of the ACA system
Conservatives were absolutely convinced that private insurers would refuse to participate in the ACA's exchange marketplaces, repeating the prediction over and over again. This also proved to be the opposite of the truth, as insurance companies have been eager to compete for Americans' business.
Failed Prediction #4: The economy will suffer terribly because of 'Obamacare'
Among Republicans, there was near-certainty that 2014 -- the first full year for ACA implementation -- would be an abysmal year for the American job market. After all, it seemed obvious to the right that "Obamacare" would crush job creation and push unemployment higher. In reality, 2014 was the best year for American job creation since the '90s; the unemployment has shown sharp improvement; and there's literally no evidence that the ACA had an adverse effect on economic growth at all.
Failed Prediction #5: Even if Americans enrolled, they won't pay their premiums
When the evidence started looking good for the ACA, Republicans got a little desperate, looking for ways to downplay good news, and the "people won't pay their premiums" talking point took root. It was, however, completely wrong.
Failed Prediction #6: Even if people pay their premiums, the flawed ACA structure will send premiums soaring
Those hoping to see the American system fail counted on soaring insurance premiums. This just hasn't happened and the ACA model has proven to be quite effective.
Failed Prediction #7: The ACA won't reduce the uninsured rate because it will only help those who already have coverage
This was a GOP favorite for quite a while, right up until the evidence proved the right had this backwards, too.
Failed Prediction #8: The ACA will lead to a "net loss" on overall coverage
This line was pushed by House Speaker John Boehner (R-Ohio) for a while, with the Republican leader arguing a year ago that "Obamacare" would end coverage for more people than it would expand coverage to, "a net loss." Boehner said, "I actually do believe that to be the case." As it turns out, his actual beliefs were ridiculously wrong.
Failed Prediction #9: The ACA will lead to higher deficits and a weaker fiscal footing for the nation
One of the projections that never sat well for Republicans, who sometimes pretend to care about the deficit, was that "Obamacare" would reduce the nation's deficit by hundreds of billions of dollars in the coming years. The GOP assumed the non-partisan budget analyses were wrong and proceeded to tell the country the law would make the deficit larger and "bankrupt" the country. According to the Congressional Budget Office, however, Republicans got this backwards, too. In fact, the overall price tag of the ACA is now smaller than previously projected.
Failed Prediction #10: Americans will end up hating the coverage they receive through the ACA
Customer satisfaction rates came as a huge surprise to Republicans, who expected the opposite results: "A majority of Americans give good reviews for insurance they recently acquired through government exchanges within the past year, a new poll shows. With the second round of Obamacare enrollment set to begin on Saturday, 71 percent said their coverage through the exchanges was good or excellent, according to a Gallup poll released Friday. Another 19 percent said the coverage was fair, while 9 percent rated it poorly."
That's 10 failed predictions and we could keep going. ACA critics were wrong about the "death spiral." And "rate shock." And the notion that young people wouldn't enroll. And assertions that Medicare patients would suffer. None of these predictions -- literally, none of them -- stood up to scrutiny.
Making matters slightly worse, five years later, none of the prominent figures in Republican politics who were wrong are willing to take responsibility for their failed predictions. On the contrary, there's apparently no real accountability at all -- the same GOP policymakers who've been wrong about every aspect of the debate haven't even tried to offer an explanation for their mistakes and misjudgments. They're far too busy scheduling dozens of floor votes to repeal the successful law and have neither the time nor the inclination to explain their abysmal predictive powers and fact-free critiques (or offer a credible alternative).
The debate has descended into an unsatisfying dialog between those who can point to evidence and those who say the law is a "disaster" out of habit, without regard for substance or reality.
Five years after the White House signing ceremony, however, the facts are not in dispute among those who choose to see them.