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News / Opinion / Columns

Westneat: Obamacare all grown up in Washington

By Danny Westneat
Published: April 10, 2024, 6:01am

Our old friend-enemy “Obamacare” is back in the news. Remember the supposed job-killing, freedom-smothering health policy we fought over like gladiators for years?

It turns out the number of people getting their health coverage through former President Barack Obama’s Affordable Care Act has soared to 45 million nationwide, up about 70 percent from five years ago. Recently, the federal government released a state-by-state analysis of Obamacare’s 10-year history, a tortuous path. In Washington, it’s now covering just shy of 1 million people.

Imagine that. Obamacare is all grown up.

And what a strange trip it has been. I recall when the program was struggling to enroll its first 40,000 people in this state, back in late 2013, during that infamous first sign-up period. Remember “Slowbamacare,” when the website kept crashing? Remember Republicans voting 50 times to kill it before it even debuted?

“Ten thousand enrollees in this state, soon to be 20,000, then 40,000 — by next week it will be 60,000, or more,” I wrote in 2013.

“Republicans are no longer fighting a specter,” I predicted. “Obamacare is going from caricature to fact. … Repealing it today means looking some constituents in the eye and saying: That security you just got? Sorry. We’re taking it back.”

I guess this is a rare one I got right.

Because with officially 971,463 Washingtonians under age 65 now getting health care through Obamacare, the once-pariah program roughly matches the size of Medicare, the popular government health plan for seniors. It also has dropped the uninsured rate in Washington from 14 percent to 6 percent.

With all the screw-ups and botched messaging, it wasn’t easy being an Obamacare defender back in the day. Like after I wrote the words above and a guy called offering to perform a colonoscopy on me with a rolled-up Obamacare policy.

I never quite got why everyone was so riled up. It was health insurance. Looking back, it was clearly the beginning of an era where policy was less the point; it was about a polarized culture war.

A couple of curious things happened on the way to Obamacare’s predicted “death spiral,” though. It was loathed only up until the moment Republicans got serious about getting rid of it. Overnight, the issue shifted from “What are you doing to us?” to “What are you taking away?”

Now people are signing up in droves not because they’ve been told to but because subsidies in the law make it attractive. This year, about 700,000 qualified for Medicaid in Washington under Obamacare’s expansion, and another 273,000 got help buying Obamacare plans in the marketplace — up 18 percent from a year ago.

Intriguingly, there are five counties in Washington where half of the nonsenior population is on government insurance or Obamacare policies, most of which are subsidized. (Over 65 is not included in these calculations, as they already have Medicare.)

All five counties are in Eastern Washington — Adams (57 percent government-covered), Ferry (56 percent), Okanogan (56 percent), Pend Oreille (54 percent) and Yakima (53 percent). By contrast, King County is at just 25 percent (meaning most health coverage in King remains employer-based). This means some of the red counties are tipping over toward the very thing their leaders say they are adamantly against.

All five counties have twice voted for Donald Trump, who is again threatening to “terminate” Obamacare and replace it. “Obamacare Sucks!!!” Trump said a few months ago, making his position pretty easy to decipher.

What next? I would wager that if deep-red Adams County is heading toward taxpayer-assisted health coverage for all, then so is the rest of the country.

Remember the phrase “If you like your health plan, you can keep it”? That was Obama’s too-facile sales pitch that turned out not to be true, touching off a backlash. A final irony is that 15 years later, the plan people are now starting to like is Obamacare.

I bet they’re gonna want to keep it.

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