Sen. Bernard Sanders is inflating his role in the creation of Obamacare, analysts and fact-checkers say, but his claim is driven by a simple political reality — his core supporters are the most ardent backers of the health care law, leaving him little choice but to praise the legislation even as he tries to scrap it in favor of a costly single-payer system.
Mr. Sanders’ assertion Monday at the Democratic presidential debate that he “helped write” the Affordable Care Act seems to be an exaggeration at best, and some health care analysts say he had little to do with the formation of the mammoth legislation.
Others say Mr. Sanders earns some share of the credit, or blame, by virtue of serving on the Senate Health, Education, Labor and Pensions Committee, which had jurisdiction over a version of the bill in 2009 — but so could the 43 other senators, and particularly the 25 Democrats who sat on that panel or the Senate Finance Committee, which was also involved in the writing.
“Every one of them” played a part in writing the bill, said John E. McDonough, a professor at Harvard University’s School of Public Health who advised the Senate health committee when the legislation was in development. “There are pieces in there because of them, and a generous interpretation of that means you’re involved with writing the bill.”
Mr. Sanders undoubtedly was the driving force behind $11 billion in funding for community health care centers contained in the ACA, but there are few, if any, other examples of his fingerprints on the law.
His role came under scrutiny as he tried to fend off charges from top presidential opponent Hillary Clinton, who says his proposed $1.38 trillion per year government-run health care system shows he is trying to undo President Obama’s chief accomplishment.
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“We’re not going to tear up the Affordable Care Act. I helped write it,” Mr. Sanders said in defense, though he also has long maintained that the law doesn’t go far enough. He said as much when the bill was signed into law in 2010 and has stuck to that position throughout the campaign.
His campaign didn’t respond to a request for comment for this article, but political analysts said he is wise to straddle both sides of the Obamacare question for now and offer his Medicare-for-all overhaul of the health care system while insisting he is improving, not scrapping, the Affordable Care Act.
“Sanders has to defend the ACA because it is popular among his core constituents. Many of his supporters have benefited from the law and think highly of President Obama. Claiming to have helped write parts of the law helps Sanders politically,” said Darrell West, vice president and director of governance studies at the Brookings Institution.
Indeed, polling shows Mr. Sanders’ strongest supporters also have the highest opinions of the ACA.
Polling data from the Henry J. Kaiser Family Foundation found that Democrats view the law much more favorably than Republicans. More important, young and low-income voters — two groups that strongly prefer Mr. Sanders over Mrs. Clinton — have especially positive views of the law.
Forty-three percent of voters making under $40,000 say they have a favorable opinion of the ACA, compared with 37 percent of those making $40,000 to $90,000 and 35 percent of those making over $90,000, Kaiser polling shows.
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Surveys consistently have shown Mr. Sanders faring much better than Mrs. Clinton among low-income voters.
The same holds true among young voters, and that same bloc largely supports the ACA.
Forty-nine percent of voters ages 18 to 29 have favorable opinions of the law, the highest level of support of any age group, Kaiser polling shows. On the other hand, 39 percent of voters ages 50 to 69 view the law favorably.
Those figures, political observers say, underscore why Mr. Sanders must cling to the ACA and cast his own health care proposal not as a complete overhaul of the system — which it is — but instead as the natural next step in progressives’ dream of universal coverage.
“Sanders has unabashedly said he will raise taxes to pay for his universal health care plan in exchange for getting rid of health care payments, such as subsidies and premiums. He has to get a buy in on that,” said G. Terry Madonna, a political analyst and professor of public affairs at Pennsylvania’s Franklin & Marshall College. “That will play well in Democratic circles, but he has to walk gingerly around the ACA because it’s Obama’s major domestic legacy piece.”
As for Mr. Sanders’ role in crafting the bill, other health care specialists and fact-checkers say he is off base.
The fact-checking outlet Politifact said his claim of helping to write the ACA is “mostly false.”
Jonathan Gruber, ACA architect and Massachusetts Institute of Technology professor, told Buzzfeed last week that Mr. Sanders was “not a leader on the legislation.”
Other analysts agree.
“I don’t remember him having any leadership role in the creation of the ACA. In fact, I don’t remember his name ever coming up during the ACA’s formative period,” said Robert Laszewski, president of the Washington consulting firm Health Policy and Strategy Associates LLC.
• Ben Wolfgang can be reached at bwolfgang@washingtontimes.com.
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