How health-care reform went wrong

How health-care reform went wrong

“Working in the White House on a Saturday afternoon had become routine for Zeke Emanuel and Bob Kocher,” Steven Brill tells us at the beginning of Chapter 9 of his ambitious new history of the Affordable Care Act, “America’s Bitter Pill” (Random House):

But they were usually able to leave at a decent hour. However, at 5 p.m. on Saturday, April 25, 2009, they were thrown into a state of near-panic. Emanuel, Kocher, and the rest of the staff from the Office of Management and Budget and the National Economic Council had been blindsided by the domestic policy crew.

At issue was a briefing paper written by the head of the White House health-care-reform effort, Nancy-Ann DeParle. It was early in the planning stages for Obamacare, and DeParle’s memo was a three-thousand-word document, in which she made the political case for a broad expansion of coverage. Kocher and Emanuel were taken aback. They were worried about the cost of the bill. The memo was supposed to go to the President at eight o’clock that night, which gave them just three hours to respond. “Any hopes for an early departure that Saturday evening were gone,” Brill writes.

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