WASHINGTON – Angry Americans voice outrage at being asked to pay more for health coverage. Lawmakers and the White House say the public just doesn’t appreciate the benefits of the new health law. Opponents clamor for repeal before the program fully kicks in.
The year was 1989, and the law was the Medicare Catastrophic Coverage Act, which was supposed to protect older Americans from bankruptcy because of medical bills. Instead it became a catastrophe for Democratic and Republican lawmakers, who learned the hard way that many older Americans did not want to be helped in that particular way.
Seventeen months after President Ronald Reagan signed the measure with Rose Garden fanfare, a series of miscalculations and missteps in passing the law became painfully evident, and it was unceremoniously stricken from the books by lawmakers who could not see its demise come quickly enough.
The tortured history of the catastrophic-care law is a cautionary tale in the context of the struggle over the new health law, the Affordable Care Act. It illustrates the political and policy hazards of presenting sweeping health system changes to consumers who might not be prepared for them. And it provides a rare example of lawmakers who were willing to jettison a big piece of social policy legislation when the risks – that is, the political risks – became too grave.
“It has often been said that if you get an entitlement on the books, you can never get rid of it,” said Bill Archer, who pushed to repeal the 1988 law as a senior Republican, from Texas, on the House Ways and Means Committee. “That is an example of a time we did get rid of it.”
Backers of the Affordable Care Act say comparisons to the catastrophic-care debacle are flawed. They say that the new law fills a major health insurance void and that despite its current problems, it will never meet the same fate as that undertaking in 1988.
“It is enormously different,” said Ron Pollack, the executive director of Families USA, a liberal consumer advocacy group, who supported both the new health law and the catastrophic-care program. “You had a benefit totally paid for by 40 percent of the Medicare beneficiaries, who overwhelmingly thought there was not a benefit there for them. It is understandable they were upset.”
On Sunday, top congressional Democrats on Sunday stood by President Obama and the flawed rollout of the government’s health-care website, expressing confidence the problems would be fixed and the issue would not drag down the party in next year’s mid-term elections.
“I don’t think you can tell what will happen next year, but I will tell you this – Democrats stand tall in support of the Affordable Care Act,” House Minority Leader Nancy Pelosi, D-Calif., said on NBC’s “Meet the Press.”
But Republicans said Democrats were trying to gloss over the problems with the law.
“No matter how much Congresswoman Pelosi tries to spin this, this is a mess,” Sen. Kelly Ayotte, R-N.H., said on “Meet the Press.” “My constituents are very unhappy with the notices they’re receiving and higher premiums.”
Some involved with the passage and repeal of the Medicare Catastrophic Coverage Act see clear parallels with the current situation, in which a very vocal minority that views itself as harmed by the new law has joined with highly organized political operations to rally opposition to it.
“When I saw this massive thing, I said, ‘Boy, if this is anything like catastrophic, they are going to be in trouble,’ ” said Brian J. Donnelly, who led the 1989 repeal effort as a Massachusetts Democrat on the Ways and Means Committee. “It is a very good analogy.”
The Los Angeles Times contributed to this report.