MEDICAID, THE BBB, AND OBAMA’S REVENGE. It’s reasonable to view the angry debate over the Medicaid provisions of the recently signed-into-law One Big Beautiful Bill Act, with Democrats accusing President Donald Trump and Republicans of taking away healthcare from millions of people, as the inevitable result of the scheme that then-President Barack Obama and Democrats set in motion in 2010. Back then, many in the party wanted to create a single-payer national healthcare system but did not have the political support to do so. So Democratic leaders debated among themselves about how to get as far as they could with their existing (big) majorities in the House and Senate. After much effort, they came up with the Affordable Care Act, better known as Obamacare, which they passed during a brief period in which they had 60 seats in the Senate. 

Obama and his fellow Democrats knew Republicans wanted to repeal Obamacare — GOP lawmakers said so every day. So Democrats made Obamacare extremely difficult and politically risky to touch, much less eliminate. As time went by, there would be political hell to pay for changing, even improving, the system. That’s what we’re seeing play out now with Republican efforts to reform Medicaid in the “big, beautiful bill.”

Back in 2010, one prominent Democrat called Obamacare a “starter home, suitable for improvement” — that is, you buy as much house as you can, then next year you add a bedroom, and the year after you add a den, and so on. In terms of Obamacare, the idea was, let’s start with this, add to it as often as we can, and make our way toward single-payer national healthcare.

One major part of the starter home was expanding Medicaid. Begun in 1965, Medicaid was created to assist certain groups of the non-elderly poor: young children, pregnant women, and the disabled. One group not intended for........

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