Obama returns to White House for celebration of Affordable Care Act as Biden announces changes to law

Former President Barack Obama made his first public appearance at the White House since leaving office, attending a Tuesday event celebrating the Affordable Care Act (ACA) where President Biden announced a change to the health care law intended to give some Americans the ability to buy cheaper plans.

“It’s good to be back in the White House,” Obama said at the ceremony after being introduced by Vice President Kamala Harris. “I confess some changes have been made by the current president since I was last here. Apparently Secret Service agents have to wear aviator glasses now, the Navy Mess has been replaced by a Baskin-Robbins and there’s a cat running around.”

The ceremony honoring the ACA, the 2010 health care law also referred to as Obamacare, marked Obama’s first visit to the White House since he left office in January 2017. The former president opened his remarks by jokingly referring to Biden as vice president, the role he served under Obama from 2009 to 2017. He also called him “an extraordinary friend and partner,” listing their accomplishments and saying nothing made him prouder than the ACA, “which is why you run for office in the first place.”

“It’s fitting the first time you return to the White House is to celebrate a law that is transforming millions of lives because of you,” Biden said, after stating it felt like the good old days having lunch with his former boss. “And I say because of you, you had a lot of help — staff, and I helped a little bit — was because of you. A law that shows hope leads to change, and you did that. Let’s be honest, the Affordable Care Act has been called a lot of things, but 'Obamacare' is the most fitting.”

“We both understood the Affordable Care Act wasn’t about a single president or the presidency,” Biden continued. “It was about the countless Americans lying in bed at night, staring at the ceiling, wondering, ‘My God, my God, what if I get really sick? What am I going to do? What is my family going to do?’”

According to a 2020 analysis by the Urban Institute, about 21 million people are covered by the law. Provisions in the ACA include protections for Americans with preexisting conditions as well as an expansion in most states of Medicaid, a program that covers those with lower incomes and disabilities. While the law was unpopular in its early days, tracking from the Kaiser Family Foundation in March showed that 55% of Americans support the law, versus 42% who are opposed.

During his remarks, Biden announced changes to the plan in an attempt to expand it to more Americans. One tweak that can be authorized by the Treasury Department is fixing a “family glitch” that would mean lower premiums for some Americans, while others would become eligible for subsidized insurance plans.

“Once today’s proposed rule is finalized, starting next year working families in America will get the help they need to afford full family coverage — everyone in the family,” Biden said.

Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, called the move the “biggest step the Biden Administration could take without Congress to improve affordability under the ACA.” The administration also called for Congress to make permanent the subsidies that were part of the pandemic relief package passed last year and are set to expire in December.

Obama signed the ACA into law in March 2010, immediately making it a top target for Republicans, who vowed to repeal it. The first attempts came via the Supreme Court, but the law survived rulings in 2012 and 2015, although portions of it were carved out, including allowing states to opt out of the Medicaid expansion.

In 2017, with Donald Trump in the White House and the GOP controlling both chambers of Congress, they came close to repealing it, but the move failed in the Senate after three Republicans (Susan Collins of Maine, John McCain of Arizona and Lisa Murkowski of Alaska) voted to reject the repeal. Alternatives proposed by Republicans such as the American Health Care Plan were wildly unpopular and would have left millions of Americans without health care. Trump promised to propose a “fantastic” plan throughout his 2016 campaign and presidency, but he never unveiled a detailed proposal during his four years in office.

“Now, I have to tell you, it’s an unbelievably complex subject,” Trump said in February 2017, shortly after taking office. “Nobody knew health care could be so complicated.”

Republicans did manage to repeal the individual mandate — the penalty that required anyone who didn’t have health care to pay a fine to the government — as part of their 2017 tax plan. This inspired another Supreme Court challenge to the ACA, which critics said could not exist without the mandate. In June 2021, the court again upheld the law in a 7-2 ruling, stating that the GOP-controlled states challenging the law did not have standing to do so.

“They’re unrelenting,” Biden said of the Republican challenges. “They haven’t stopped. Mr. President, since you signed the law they haven’t stopped for one second. Multiple court challenges you mentioned, sabotage from the previous administration. Over 70 attempts to repeal the law by Republicans in Congress.”

Biden also noted comments last month from Sen. Ron Johnson, R-Wis., who said the law should be repealed if the GOP takes power again.

“For example, if we’re going to repeal and replace Obamacare — I still think we need to fix our health care system — we need to have the plan ahead of time so that once we get in office, we can implement it immediately, not knock around like we did last time and fail,” Johnson said on Breitbart News Radio.

Republicans have not been the only critics of the law, which was based on ideas by the conservative Heritage Foundation that were first enacted in 2006 by then-Massachusetts Gov. Mitt Romney, a Republican who ran for president in 2012 saying he would repeal the ACA. He later took credit for the law, which led to millions of people gaining health insurance. (During Romney’s first run for president in 2008, he touted his experience implementing health care reform on the campaign trail.)

Progressives have pushed for Medicare for All (a single-payer program in which the government provides health insurance for everyone), which Obama called a “good idea” in a 2018 speech. During his comments Tuesday, he said the ACA was a “starter home ... that secured the principle of universal health care” and needed to be improved.

In doing so, progressive critics cite the millions still without insurance, the large payments to insurance companies and the high costs of premiums, copays, deductibles and prescription drugs. Democrats have campaigned on lowering the cost of prescription drugs for years, but have fallen short due to opposition from Republicans and centrist members of their own party.

Days before Obama’s appearance at the White House, one of his former top staff members noted that the cost of his prescriptions was going up.

“I've been taking an RX for a chronic condition for years,” wrote David Axelrod, a chief campaign strategist and senior adviser. “This week, I learned my insurance no longer covers it. Now the cost is $639-a-month! How many people can afford that? ‘Your money or your life’ is a hell of choice that people shouldn't have to face."

The tweet went viral, as many noted that the Obama administration had implemented much of the framework for the current health care system, and that Axelrod himself had spoken at a conference for a lobbying group that opposed more substantial changes. Among those who weighed in was Rep. Alexandria Ocasio-Cortez, D-N.Y., one of the country’s most prominent progressives.

“When I waitressed, I had to pay $100s/month for the privilege of paying thousands in deductibles each year for ACA insurance that didn’t really cover RXs,” tweeted Ocasio-Cortez. “It was cheaper/the best $ option to just go uninsured and prayed nothing happened. One reason why I support Medicare for All. I remember vividly one day I decided to walk around and ask everyone I worked with — waiters, bussers, cooks — what insurance they had. Everyone had the same answer: none. It was better for us to save up the money we’d otherwise pay on premiums & spend it on actual medicine/care.”