Former congressman Bart Stupak was the lynchpin of health reform's passage, and he paid a price for it in the end.
The pro-life, Michigan Democrat led a small but powerful bloc of Democratic lawmakers to oppose the bill because of its language on federal funding of abortions. Seemingly at the last minute, Stupak and the White House hammered out a compromise, his pro-life allies supported the bill, and it passed by a thin margin.
After that, Stupak received a death threat. Facing outside spending in his district and a vitriolic political climate, he decided not to run for reelection. Now, he's a visiting fellow at Harvard's Institute of Politics.
On health care reform's first birthday, Stupak told The Atlantic about getting "bitch[ed] out" by angry citizens in airports, how he and President Obama reached the deal that secured the bill's passage, and that Rahm Emanuel knows better than to get in his face.
A lightly edited transcript, with some questions and parts of answers excised:
How do you look back on health care reform now, as a time in American politics and as a moment in Congress?
Well it certainly was a historic debate. It wasn't Congress's best time, especially when you had people like some Republican members off the Speaker's Lobby urging protesters on the ground--I thought that was unbecoming of members of Congress--and you know members were spit on and threatened as they walked over to vote. I don't think that was a very glorious moment in our history, but from a historical point of view the health care legislation is historic. It's the law of the land, and it's being implemented. And I find it amusing that even states that declare it unconstitutional are implementing it.
Are you still a supporter of the law?
Oh, absolutely. It's not the most perfect law, and there's going to be changes--we all know that--but, boy, it's a good foundation from which to build off.
What do you think, specifically, could change about it?
Well I'm sure as they go through, states will do different things. Some of the states have asked for--I don't want to say exceptions, but a waiver because they already do this part of that part, so I expect there's going to be some changes along those lines. One of the changes I see with all these things on collective bargaining, whether it's Wisconsin or wherever, if the employee's paying part of it, and the employer, being the state or whoever it is, is paying part of it, I could see them trying to spread that cost around, so you don't hit that 'Cadillac plan' insurance, which goes into effect in about 2016 I think it was, so I see some changes going on there. The challenges to the constitutionality of it, I don't see that as being threatening to it. And as with anything else, like with Medicare, there will be some changes to it.
"I still get accosted ... Fortunately, I get more pats on the back than people cussing me out."
Do you have any regrets over how it all went?
No. Nope, I always ran on health care, I did not take the federal employee health benefits package, I thought all Americans should have it before I accepted their package of benefits. I always felt strongly about health care. In fact, since the whole debate, you go back and you look at some history as I have, especially since I decided not to run again, I got an article from December of 1992 and the headline was, "Stupak's Top Priority: Health Care."
Here's a separate question from whether it's a good law: Was it good for Democrats, politically, that health care passed?
I had no trouble selling health care in my district. Some members ran from it after it passed, because people were not happy with it. I still find today, yet, a lot of confusion about the law. In fact, my wife and I hosted Menominee County Democrats at our house, and their speaker was Senator Carl Levin, and there were quite a few people there, and these were Democrats mostly, and even they were confused. Like, you know, my son's disabled and he works at a workshop and makes $9,000, you know, how's he going to afford the new health care law? Well, he won't have to worry about it. He's going to be 100 percent subsidized. 'Well, I didn't know that,' they'd say.
When you start talking about the patients' bill of rights and all the benefits that are in there, people agree with all that. What they don't know is how are you going to pay for it. I'm going off the top of my head here, but it seems to me that the law would generate, over 10 years, $1.8 trillion, and the cost was about $920 billion. There was like $160 or $190 billion going towards deficit reduction. People do not realize that because most members don't articulate that.
I actually went around my district from before the [first] vote in the House and all the way through up until the final vote in March, and people would come back after going through a town-hall meeting, after seeing the slide presentation I did, they'd say, 'Well, that makes a lot of sense.' And they weren't that angry about it. You still get people who say, 'Well, I don't want to pay for it.' Technically, you don't have to. You're going to get a little 2.5 percent charge to help pay for the infrastructure, and they object to that, but yet they want the ambulance, the EMTs, the emergency room to be there when they get hurt. So when you put it like that, they say, 'Yeah, okay, I understand that, but I don't like it.' Okay, fine. And I don't like having to pay about $1,017 a year for the uninsured that is applied to my premium.