President Joe Biden should reach out to Republicans to rekindle cooperation around one of America’s most successful and popular policy efforts—the Affordable Care Act. After eleven years of irrational attacks, the GOP should finally acknowledge that Obamacare isn’t going anywhere. Biden can now foster unity around new reform legislation which expands on the progress of providing healthcare to millions of Americans. The Affordable Care Act, or Obamacare, provides healthcare to roughly 23 million under/uninsured Americans.

Former Gov. Mitt Romney ended decades of fruitless national debate about healthcare reform in 2006 when he implemented almost universal coverage in Massachusetts. Nearly 98 percent of his residents soon enjoyed more affordable healthcare with a model which employed a public/private partnership between the state and private insurance companies.

Republicans were at first generally positive about Romneycare. However, some opposed its mandated coverage as being unconstitutional. Many Republicans soon came around to support the effort.

President Obama’s 2008 election brought a new focus on national healthcare reform. Jonathon Gruber of MIT had been instrumental in devising Romneycare. He joined experts in the Obama White House to fashion a modified public/private model that built on Romney’s earlier effort. It was adapted to accommodate the vagaries of fifty different states, but the resulting core principles still relied on the approach in Massachusetts.

The U.S. Senate quickly became the next congressional crucible in which the ACA was forged. The president was hellbent on securing bipartisan support. The Finance Committee room and adjacent hallways were a beehive of lobbying and negotiations. Insurance industry agents and friendly Republican senators offered up more than 150 amendments which eventually became law. The Republicans and their industry allies ultimately had a huge influence on the new legislation.
When the ACA eventually came up for a final vote in the U.S. Congress, Republicans made one of the most diabolical political pivots in history. Virtually overnight they suddenly opposed a bill that was laden with GOP fingerprints while also containing Romney’s seminal concepts. Somehow mandated individual coverage was suddenly anathema and unconstitutional. “Death panels” soon entered the debate over the ACA.

Democrats held majorities in both chambers of the U.S. Congress, so the ACA became law without a single Republican vote. The GOP then launched strident, ongoing political and judicial attacks which have hindered Obamacare to this day.

However, the program roughly cut in half the number of the nation’s uninsured as more than 23 million Americans signed up. The courts eventually struck down the individual mandate, but the ACA remains very popular. Gallup reports that over 50 percent of Americans support it despite the years of false partisan rhetoric and attacks.

President Biden today should vigorously remind Americans that the ACA is actually one of our greatest bipartisan achievements. President Obama deserves tremendous credit for expending the huge political capital needed to get the bill passed. Now the GOP should abandon their obsessive opposition to the only healthcare legislation that they ever contributed to that actually worked.

The ACA was never meant to stand unmodified for over a decade. It has serious administrative and policy flaws which have long needed serious attention.

Moreover, Congress has an opportunity to add important cost containment initiatives to help better curb future healthcare spending. The original legislation had language to advance “best practices” which showed promise in the various states. These mechanisms have long since withered under relentless GOP attacks. Slowing future healthcare spending is surely an idea that Republicans could enthusiastically embrace.

Joe Biden is a plain-spoken president. He should conduct as many “fireside chats” with the American people as necessary to dispel the untrue, stigmatic rhetoric that surrounds Obamacare. He needs to patiently explain new developments as emerging policy moves forward. Republicans, for their part, should finally publicly embrace their role in America’s yet unfinished healthcare reform.

The president’s professed commitment to unity can be advanced by a concerted effort to fix and expand healthcare. Republicans can also rightfully claim some of the credit. But first, Biden needs to reeducate Americans about Obamacare’s true history. Real unity requires a basic recognition of some long-standing but little understood history.