2013: When the conversation changed

  It was a bad year for the president, some would say his worst.

  The nation was divided to the breaking point. It seemed nothing went right for him in 1862.

    And yet, Abraham Lincoln, his proxies being pummeled on the battlefield, rose above it to bring about a fundamental change regarding a most basic human need.

   In Lincoln's case, that need was education. That year he signed the Morrill Act, transforming this from a nation with a permanent have-not class to one in which all could aspire to higher education.

   Reading about what many historians consider Lincoln's worst year, I thought about 2013. Even his friends say it couldn't have been worse for Barack Obama. We know what his critics say.

  However, they don't write history.

  History will show that 2013 was when America's conversation about health care changed. The nation started the excruciating, jarring shift from the status quo —  with a permanent have-not class — to something better.

  Yes, we know Congress had that conversation in 2009 and 2010, passing the Affordable Care Act. But it wasn't until 2013, with the individual mandate kicking in, that the rest of us had that talk.

  Whatever is being said now, even if obscenity-laced, is good for the country, because it's about what the nation needs.

  Want to vent about healthcare.gov? Good. The more outrage, the more quickly its problems will be addressed.

  Want to talk about the fact that some states will deprive millions of Medicaid available in other states? Good. Maybe those millions will vote.

   Want to say the president misled about unintended loss of coverage for many? OK. Say it. Say, "He lied," if you wish. But understand: The ACA is in place for people who lose their coverage. Before 2013, millions lost their insurance each year, with nowhere to turn.

     Back to 1862 and the Morrill Act, which created land-grant colleges in the states: It didn't apply to the Confederacy, which declared it didn't belong to America anymore. After peace reigned, that changed and the former breakaway states benefited as well.

    Right now, in similar fashion, the potential of the ACA is blunted in red-state America, not just on Medicaid expansion, but with states having refused to set up their own health care exchanges to help their citizens shop for coverage.

    But I have two examples from such states that illustrate the ACA is working even in hostile environs.

    Take a woman in Texas who used healthcare.gov to drop her individual health insurer (with premiums slated to go up 27 percent), and ended up with coverage at half of the projected cost, with a lower deductible.

     Easy? No. "It took several tries, and I had help." Now she knows how it works. She knows that if the plan she just purchased is insufficient or gets too costly, she can shop around with many more options than before. To her, "It's the American way."

    Meanwhile, a woman in Florida whose pre-existing condition — breast cancer — made coverage crippling, reported that because of the ACA her premiums went down and and her deductible will be cut by three-fourths.

   "For those who disparage Obamacare," she wrote in a letter to the editor, "do some research and stop believing the naysayers who have insurance and are blessed with good health."

     Sticker shock ahead for some Americans? Absolutely. Disruption of coverage? We've seen it.

     But 1 million Americans have signed up at this point, meaning there's no turning back.

     The conversation has changed. Whereas once America was resolved to the forever-inequitable status quo, it is figuring out how to address a new, fairer, reality.

     And history will show that it happened in Barack Obama's worst year.

    Longtime Texas newspaperman John Young lives in Colorado. Email: jyoungcolumn@gmail.com.