Former President Barack Obama returned to the White House for the first time in five years Tuesday to celebrate his signature health care law and resuscitate the lagging political fortunes of President Biden and Vice President Kamala Harris.
A friendly East Room crowd greeted Mr. Obama with whoops and cheers as he praised Mr. Biden and Ms. Harris for shielding his hard-won program as they push for another big expansion of social welfare and work to stave off a bloodbath in the midterm contests.
Mr. Obama said their work isn’t finished, however, as Democrats work to expand the law to cover millions more while warning that Republicans might try to chip away at benefits if they retake Congress in November.
“Today, the ACA hasn’t just survived, it’s pretty darn popular,” Mr. Obama said. “It’s done what it’s supposed to do. It’s made a difference. First 20 million, and now 30 million people have gotten covered thanks to the ACA.”
Mr. Obama said compromises necessary to get the 2010 law through Congress meant millions of people are still falling through the cracks.
He extolled Mr. Biden for fixing a so-called “family glitch” in the law that could help an estimated 200,000 people in pricy employer-based plans find more affordable coverage in the Obamacare exchanges.
“The ACA was an example of why you run for office in the first place,” Mr. Obama said. “We’re not supposed to do this just to occupy a seat or to hang onto power. We’re supposed to do this because it’s made a difference in the lives of people who sent us here.”
Mr. Obama, who lives a short drive away in Washington, came to Mr. Biden’s aid as Democrats face a potentially bruising midterm season amid concerns about inflation, global crises and fears of a potential migrant surge at the southern border.
Tuesday’s focus on Obamacare and efforts to chip away at the law’s protections for preexisting conditions allowed the administration and Democratic allies to pivot to more comfortable political terrain.
“It’s important to note that the Biden electoral coalition and the Obama electoral coalition are similar but not identical and any daylight between them needs to be closed,” said Ross Baker, a political science professor at Rutgers University.
He said Mr. Biden is struggling with White working-class voters and restoring the 2008 coalition “is essential for dealing with November headwinds.”
Mr. Obama had a bit of fun with his former No. 2, joking Secret Service agents are required to wear aviator sunglasses and there is a Baskin Robbins on White House grounds.
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He also referred to Mr. Biden as the vice president, before stopping short: “That was a joke. That was all set up.”
Mr. Biden, who dubbed the Affordable Care Act a “big f—-ing deal” at its signing, warned that Republicans will try again to repeal Obamacare if they win majorities this November.
He said he needs Democratic majorities on Capitol Hill to rally around his Build Back Better agenda to shore up Obamacare while handing Democrats another legacy-defining victory.
“Instead of destroying the Affordable Care Act, let’s keep building on it. Let’s extend it,” Mr. Biden said.
In the meantime, Mr. Biden is taking action on his own.
The Treasury Department is issuing a proposed rule to help family members who are shut out of the Affordable Care Act’s insurance exchanges if a spouse or parent is offered coverage by an employer.
An individual can access the exchanges and subsidies that defray premiums if the cost of employer-based coverage exceeds about 10% of their income, but that provision doesn’t take into account the cost to cover dependents.
The new rule will apply that affordability standard to the whole family instead of the employee alone. Therefore spouses or children, who lift the cost of premium contributions above 10% of income, can seek subsidized insurance under Obamacare.
“In the family glitch, a lot of these people have insurance, they’re just paying a lot of money for that insurance. What this would do is give them the option to move some of their family members” into the exchanges, said Cynthia Cox, a vice president at the Kaiser Family Foundation and director of its program on the health care law.
Administration officials said the family glitch affects about 5 million people in the U.S. They estimated that 200,000 will tap into Obamacare coverage in the next enrollment period due to the change.
Ms. Cox said some families might prefer to remain in a unified, pricey employer plan because the Treasury’s proposed rule will likely allow dependents to flow into the exchanges but not the actual employee with company coverage that is deemed affordable under the law.
Families might want to retain a joint deductible or out-of-pocket maximum under one plan, or coverage that applies to one set of doctors.
The administration could not provide an estimate of how much the change might cost taxpayers in terms of new subsidy payments, or how it would be paid for, though Mr. Biden hailed the change as significant.
“Working families in America will get the help they need to afford full family coverage — everyone in the family,” Mr. Biden said.
Democrats are promoting the health care program as it enjoys relative popularity after a wobbly start under Mr. Obama. Premiums skyrocketed because fewer than expected healthy people signed up for insurance while sicker people flooded the market because insurers, under the law, had to accept persons with preexisting medical conditions and could not charge them more.
The Republican National Committee slammed the White House event as an attempt by “two failed presidents” to paper over past and current failures.
“In an attempt to distract from his many other failures, including 40-year high inflation, record-high gas prices, and a border crisis, Biden is now pivoting to another policy failure — Obamacare,” the RNC’s research arm said. “Obamacare sent health insurance costs through the roof, raised taxes on the middle class, and forced employers to cut jobs and hours.”
Yet Obamacare has survived three near-fatal showdowns before the Supreme Court and attempts by former President Donald Trump and GOP lawmakers to replace the law.
Mr. Biden reopened enrollment in the exchanges that offer private insurance and income-based subsidies for much of 2021, citing the impact of the coronavirus pandemic. Democrats also made the subsidies more generous, resulting in a record-high 14.5 million Americans signing up for the current plan year.
“As we head towards November’s elections, we’re reminding voters that Democrats are proud to fight for quality, affordable health care access for Americans — while Republicans are fighting to take it away,” said Democratic Attorneys General Association co-chairs Aaron Ford of Nevada and Kathy Jennings of Delaware.
Obamacare’s supersized subsidies only last until the end of the year, however, forcing Mr. Biden to scramble for an extension.
Mr. Biden’s massive social welfare plan would extend the subsidy enhancement through 2025 but, since the broader package ran into opposition, he must find a way to get this piece across the finish line before the subsidies revert to lower levels.
Ms. Harris, who took a prominent role in the White House event by introducing Mr. Obama, said the administration is calling on Congress “to make permanent the subsidies that are included in the American Rescue Plan.”
Extending the tax credits will be “indispensable in continuing the progress in getting more and more Americans covered,” Health and Human Services Secretary Xavier Becerra told the Senate Finance Committee in a hearing across town Tuesday.
Beyond the exchanges, nearly 19 million more Americans gained coverage under Obamacare’s expansion of Medicaid insurance for the poor. Only about a dozen states have rejected federal matching funds that pay for much of the cost of covering the expansion population.
Mr. Biden praised Oklahoma and Missouri for their recent decisions to join the expansion, which experts have described as the quiet workhorse of the program even as the private-insurance portals generate most of the headlines and legal disputes.
In states like Texas and Florida, which have declined to expand Medicaid, some Americans are caught in the so-called “coverage gap” because they earn too much to qualify for Medicaid but below the poverty level — the threshold needed to qualify for Obamacare subsidies.
Mr. Biden has proposed ways to smooth over the gap by offering to put these people in a form of Obamacare-exchange coverage with low costs, though he’s pressing Congress to pass that provision as part of his Build Back Better agenda.
Ms. Harris also said Congress should approve the part of their agenda that would allow Medicare to negotiate down drug prices, an issue that polls well and could enthuse base voters ahead of the November elections.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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