Affordable Care Act survives--just barely

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Now that Barack Obama has been reelected and his party continues to hold the majority in the Senate, the Patient Protection and Affordable Care Act will survive and be implemented mostly whole in 2014.

I would like to revel in this, but I cannot just yet. Preserving the ACA was not a case of America putting its best foot forward. Healthcare reform was instead tied to a boulder for a spell--while some drunken extras from "Deliverance" held a knife-throwing contest.

This was an extraordinarily ugly election campaign, beset by the kind of racial undertones that had been swiftly beaten down during the 2008 contest, but this time around were allowed to molder and ferment like rotten eggs.

President Obama inherited the worst economic environment a president has had to confront in more than 75 years. On the day of his inauguration, the economy was shedding 750,000 jobs a month and contracting at an astonishing 9 percent annual rate.

And despite reversing that trend and signing into law the most comprehensive healthcare reform in nearly half a century little more than a year after assuming office, he faced the response of "we gave him a chance, but he just doesn't work as fast as he should."

What else to make of tortoise-like Senate Majority Leader Mitch McConnell, who despite seeing his country in the worst economic distress in his lifetime, said his number one priority was to make Obama a one-term president? And that was followed by his party's complete refusal to cross the aisles---the kind of Jim Crow-style absolutism that still gripped large parts of this nation when Obama was born.

What to make of Mitt Romney, the practically perfect exemplar of the uptight white male, spout virtually any position he thought would gain votes, even as Sarah Palin called Obama a "shuck and jiver"? Or Pop-And-Fresh stand-in John Sununu claiming the cerebral Colin Powell had decided to support Obama solely because of the color of his skin?

And then there's the media, which goaded Obama into employing sitcom-style zingers after he wasn't perceived to be combative enough during the first debate. Meanwhile, Romney was held all but harmless for steamrolling or trying to bully debate moderators.

And let's not forget the confoundingly clueless endorsement of Romney given by The Detroit News. It credited Obama for saving the automobile industry, but told a city that's nearly 90 percent black Obama shouldn't be reelected because "we believe Romney when he proclaims himself a 'car guy.'" That's the despite the fact Romney's plans for the automakers--clearly delineated in the opinion pages of The New York Times--would have certainly led to their liquidation.

Or the equally clueless endorsement by the Des Moines Register, which proclaimed both men "superbly qualified" but gave Romney the nod because his sketchy plan for tax cuts he clearly couldn't pay for "goes beyond helping the middle class."

The last time the Register endorsed a Republican? Richard Nixon in 1972. And as Nixon staffer and convicted felon G. Gordon Liddy might tell you, it also was about the last time the media asked big questions and dug deep.

The few diggers who remain were all but trampled. Nate Silver, the brilliant statistician who got this election precisely right in his Five Thirty Eight blog for The New York Times, methodically explained for months that Obama's chances for reelection were relatively strong, while pundits breathlessly said the race was too close to call. For that he was attacked on everything from his math to his sexual orientation.

And finally, there was Silver's colleague at the Times, David Brooks, a rare conservative who traffics in facts but did a lot of shuck and jiving himself to justify Romney's election. His theory: The country would be better off if Romney won because he could achieve bipartisanship (suggesting Democrats are more likely to compromise than Republicans). In other words, deal with those political leaders who cut off the President during a national time of need by rewarding them with more power.

Quite frankly, the fate of ACA hinged far too closely on an anonymous hotel bartender who surreptitiously videotaped Romney's "47 percent" comments, and one too many ignorant remarks by Senate candidates on rape babies.

But for now, the ACA is here to stay. Yet depending on the 2014 mid-term elections, there could be a whole new effort to defund or repeal it. Liberty University, the nexus of right-wing evangelical politics in this country, is trying even now to get another Supreme Court review.

Although Obama has been reelected, it likely will be closer to the end of the decade before the same could be said of healthcare reform. But we can move forward for now. - Ron (@FierceHealth)