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Democrats recognized that if you were going to make one governmental program that would help working class Americans, improving health care coverage would be a good choice.
By 2007, 45 million Americans had no health insurance [note 1]. These were the people who had jobs and were not eligible for Medicaid, but whose employer did not offer affordable health insurance. They were not necessarily poor, but we’re not talking about lawyers, doctors, or CEOs either. Many people were one health emergency or one layoff away from medical and financial disaster.
The Clinton Administration tried but failed to pass comprehensive health care reform. Afterwards, First Lady Hillary Clinton championed the Children’s Health Insurance Program to cover all uninsured children. The bill was passed by bipartisan majorities in Congress.
The Obama Administration extended health insurance coverage with the Patient Protection and Affordable Care Act (2010). Not only did it reduce the number of uninsured by about 20 million, it protected many more people with pre-existing conditions who could lose insurance if they changed jobs or moved [note 2].
Republicans fought the bill at every step [note 3], even though Obama tried to build consensus by basing the bill on a state law signed by a Republican governor. Fox News demonized it, almost no Republicans in Congress voted for it, and Republican governors tried to block it. Donald Trump came into office promising to repeal it and replace it with something better; he did neither. Asked this year what a better plan would be, he said he didn’t have a plan, “But I have concepts of a plan.” What that is remains unclear.