ObamaCare author: Health law is 'really complicated'

Sen. Tom HarkinTom HarkinDo candidates care about our health or just how much it costs? The Hill's 12:30 Report Mark Mellman: Parsing the primary processes MORE, one of the co-authors of the Affordable Care Act, now thinks Democrats may have been better off not passing it at all and holding out for a better bill.

The Iowa Democrat who chairs the Senate Health, Education, Labor and Pensions Committee, laments the complexity of legislation the Senate passed five years ago.

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He wonders in hindsight whether the law was made overly complicated to satisfy the political concerns of a few Democratic centrists who have since left Congress. 

“We had the power to do it in a way that would have simplified healthcare, made it more efficient and made it less costly and we didn’t do it,” Harkin told The Hill. “So I look back and say we should have either done it the correct way or not done anything at all.

“What we did is we muddled through and we got a system that is complex, convoluted, needs probably some corrections and still rewards the insurance companies extensively,” he added.

Harkin said the sweeping healthcare reform bill included important reforms such as preventing insurance companies from discriminating against people with pre-existing conditions and keeping young adults on their parents’ health insurance plans until age 26.

He also lauded the law’s focus on preventing disease by encouraging healthy habits, something he contributed to by drafting the Healthier Lifestyles and Prevention America Act, which informed ObamaCare.

But he believes the nation might have been better off if Democrats didn’t bow to political pressure and settle for a policy solution he views as inferior to government-provided health insurance.

“All that’s good. All the prevention stuff is good but it’s just really complicated. It doesn’t have to be that complicated,” he said of the Affordable Care Act.  

Harkin, who is retiring at the end of this Congress, says in retrospect the Democratic-controlled Senate and House should have enacted a single-payer healthcare system or a public option to give the uninsured access to government-run health plans that compete with private insurance companies.

“We had the votes in ’09. We had a huge majority in the House, we had 60 votes in the Senate,” he said.

He believes Congress should have enacted “single-payer right from the get-go or at least put a public option would have simplified a lot.”

“We had the votes to do that and we blew it,” he said.

Many liberals at the time expressed deep disappointment that the huge Democratic majorities in the Senate and House failed to pass a public option. It was the first time since 1978 that Democrats had a filibuster-proof Senate majority.

Harkin’s comments come on the heels of a speech delivered by Sen. Charles SchumerCharles SchumerSanders tests Wasserman Schultz Puerto Rico debt relief faces serious challenges in Senate Overnight Healthcare: House, Senate on collision course over Zika funding MORE (N.Y.), the third-ranking Democratic leader, last week questioning the wisdom of focusing on healthcare reform in 2009 and the start of 2010. 

Schumer argued that Democrats should have continued to propose middle class-targeted economic programs in the wake of the 2008 financial collapse.

“Unfortunately Democrats blew the opportunity the American people gave them,” he said. “We took their mandate and put all of our focus on the wrong problem — healthcare reform.”

Schumer acknowledged problems in the healthcare system, including the plight of millions of uninsured people, needed to be addressed but argued that’s not what voters wanted when they elected President Obama in a landslide.

His criticism was more targeted at the political timing of the law than its substance, which he believes has helped reduce healthcare costs significantly.

Harkin, however, believes Obama and Democratic leaders could have enacted better policy had they stood up to three centrists who balked at the public option: Sens. Joe Lieberman (Conn.), a Democrat turned independent, Blanche Lincoln (D-Ark.) and Ben Nelson (D-Neb.).

He argues they could have been persuaded to vote for the legislation if Obama had put more effort into lobbying them.

“The House passed public option. We had the votes in the Senate for cloture,” he said.

“There were only three Democrats that held out and we could have had those three,” he added. "We had “[Sen.] Mark PryorMark PryorEx-Sen. Kay Hagan joins lobby firm Top Democrats are no advocates for DC statehood Ex-Sen. Landrieu joins law and lobby firm MORE [D-Ark.] so we could have had Lincoln. We could have had all three of them if the president would have been just willing to do some political things but he wouldn’t do it."

Harkin and other liberals are now faced with the bitter irony that the centrists tried to placate five years ago by crafting a labyrinthine market-based reform are now all out of the Senate.

“So as a result we’ve got this complicated thing out there called the Affordable Care Act,” he said.

He believes Congress should have moved legislation in the first 100 days after Obama’s inauguration, which drew over a million people to the National Mall on a frigid January day.   

“There’s this old saying, ‘If you have the votes, vote. If you don’t, talk.’ We had the votes but we talked,” he said.

Then-Senate Finance Committee Chairman Max BaucusMax BaucusWyden unveils business tax proposal College endowments under scrutiny The chaotic fight for ObamaCare MORE (D-Mont.) held listening sessions with Republican senators for months but ultimately failed to pick up a single GOP vote on the floor.

Harkin acknowledged, however, that knowing what’s right is always much easier in hindsight. 

“I can Monday-morning quarterback with the best of them,” he quipped.