Medicare Part D, a key component of the bill, provided prescription drug benefits to seniors for the first time. The bill was opposed by virtually all Democrats over concerns that its more than $400 billion price tag wasn't paid for and over restrictions that prohibited the government from negotiating discounts with pharmaceutical companies that could reap a huge windfalls from newly insured seniors.
In the battle over the Medicare prescription drug benefit, one party used its majority to run roughshod over its opposition. Sound familiar? What's different is what happened after the law went into effect in 2006. Former foes worked to support the law however grudgingly. There were no efforts to "kill the bill." No threats to shut the government down unless the law was gutted.
Even after the Bush administration botched the rollout, Democrats didn't demand the president repeal the law and start over. In fact, Democrat-led states like New Jersey spent millions to cover the prescription costs for needy people while the federal government got its act together. Organizations that had opposed the bill counseled seniors on how to enroll and navigate the difficult application process and its infamous "doughnut hole," and they advocated for improvements to the law.
With the Affordable Care Act (aka Obamacare), it's a different world. Republican states are barring navigators from state facilities and challenging government media campaigns to promote the new federal benefit. Governor Chris Christie is ignoring the state's reputation as a strong insurance regulator. Instead, he's letting the federal government implement the crucial health insurance marketplace (aka exchange), the place where low-income New Jerseyans eligible for subsidies can purchase their coverage. As a result, New Jersey has received just $2 million to inform its citizens about their new health insurance options versus the $27 million that New York is spending. Even worse, Governor Christie has thus far refused to use several million dollars in unspent health insurance exchange setup funds to market this valuable benefit. The situation in Pennsylvania is no better.