an insurance update, and the election

Here is an article from the New England Journal of Medicine about what happens to Americans who do not have medical insurance.

The author states that many of his clinic's uninsured patients do not understand that under the Affordable Care Act, they might be able to get insurance. All that they have heard is that they will be fined for not having insurance, and the opponents of the ACA have seen to it that they do not hear the other part: the subsidies to help low-income people pay for it – sufficient subsidies for many people among the "working poor" to entirely pay the premium.

That is, unless they fall in the “Medicaid Gap.” The intent of the ACA was that for persons who are below the poverty line, the states would expand Medicaid (with financial support from the federal government) to cover them. But many “Red State” governments have refused to do so, leaving lots of their citizens without any coverage. For example, in Mississippi, a single adult's monthly income must be under $403 a month to be eligible for Medicaid ($4,836/year). For a couple: $542/month. The poverty line is $11,490 a year for one person, $15,510 for a couple. A lot of people fall in that gap, and even with the ACA, they will continue to be uninsured. But they must blame their state government for that, not “Obamacare.” Also, they could blame the Supreme Court: their ruling overturned the original requirement in the ACA that the states expand Medicaid to include everyone below the poverty line.


As for me and my wife, it turns out that we will not need the Health Care Marketplace after all. To their credit, my wife's employer, the Kohl's Corporation, has revamped their medical insurance, and we have now registered for coverage beginning January 2014. It is better coverage than our Blue Cross policy at a discount of about $200 a month from what we are currently paying.

Where the ACA enters into this is the fact that we do not have to worry about insurance and pre-existing conditions if my wife loses her job – a constant possibility in retail.

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As for the upcoming election, we are now receiving a flyer from “Americans for Prosperity” in each day's mail. Yesterday's compared our town to Detroit, insinuating that we are on the fast track to a similar bankruptcy and ruin.

I worked in another political campaign several years ago, and I know how much it costs to send a bulk mailing to the voters of our town – about $4,000. Every day. When in past city elections, that was how much most of the candidates spent for the whole campaign.

And that is not counting the phone banks, the door-to-door canvassing, the advertising....

We are hearing a lot from the AFP, and almost nothing from the other candidates – their voices are being drowned out. And that is the plan.

A Local Election

Tuesday, November 5: The general election in our community (that is, the town of 20,000 where I live, which is not the same as the community in which I work) has only one matter on the ballot: the election of a mayor and three members of the city council.

Normally, such elections are of marginal interest, with low turnout. It may be different this time, thanks in part to the presence of Americans for Prosperity. If you are unfamiliar with them, you might take a moment to peruse the applicable Wikipedia article.

AFP is widely known for its leading role in the Republican takeover of the House of Representatives in the 2010 election, and for its attacks on President Obama during the 2008 and 2012 elections. It also played an active role in the anti-union “budget reforms” of 2011 in Wisconsin.

What are they doing in my community? My theory is that we are something of a pilot project for them. Thanks to the Supreme Court “Citizens United” ruling, they have so much money from conservative billionaires that they can now expand beyond national and state politics into the local arena.

Here is my analysis of their activity in this election:

- Eighteen months to two years in advance, identify a potential “hot button” local issue that falls within their purview. I believe that their interest in our specific issue is not genuine, but it gave them a starting place.

- Provide support for low-level “educational” activities on the issue. We started seeing yard signs, occasional flyers, and letters to the editor on the subject.

- Identify local people who take an interest in the issue, and groom selected persons as potential candidates. According to reports, AFP recruited their slate of local candidates in January or February of this year. None of them have any previous experience in elected office: this is a plus, for they have no past record to defend.

- Ideally, look for an election where a takeover can be made in one sweep. In our case, the long-time mayor is retiring, and three out of five seats on the council are up for election.

- Avoid direct financial support of any candidate, as it could be counterproductive. The presence of AFP has rightly become an issue in the campaign, and all of their candidates deny any direct support from AFP, though they admit to advice and logistical support. However, one other candidate stated that she was offered $20,000 by AFP to run, and she refused the money, sensing that there were "strings attached." She has been one of those attacking the AFP candidates for the "out-of-state support" that is behind them.

- Instead, funnel money into such activities as telephone “push” polls, advertising and direct mailings that avoid naming any specific candidates that happen to agree with the views expressed. AFP representatives from the state chapter say that as the election draws near, there will be door-to-door solicitation and "other educational efforts not tied to any candidate."

- Turn it into a one-issue election. Hammer on the selected issue at every opportunity; defuse any discussion of other potential issues. This has been the clear pattern in the three candidates' forums. By this time, thanks to almost two years of preparation, the selected issue is at least vaguely in the back of most voters' minds, even those who pay little attention to local politics (which is nearly all of them). In the final weeks, the goal is to bring the issue to the forefront of every voter's mind.

- Use sufficient funds so as to overwhelm what any local candidate could do. I have read estimates that past council candidates have spent sums in the area of $4,000 or $5,000. In this case, if the AFP money is counted, the amount per seat is more on the order of $20,000 and up. Be it noted that these estimates have been made by liberal organizations hostile to AFP's mission, so take them with a grain of salt.

So far, we have not seen the vicious personal attacks for which AFP became well-known in the Obama campaigns and various congressional campaigns. Such attacks would be more likely to backfire in a small-town election. But the direct mailings we have received are clearly from the same hands, down to the layout and graphic design. They tend to sensationalist one-liners that are at best misleading and sometimes entirely false.

I encourage you to watch for this pattern in your community. If you have local offices up for election on November 5, pay attention to them. Educate yourself about the candidates – it is much easier to do in this day through the Internet than it was in the old days.

Henry Martyn (1781-1812)

from Kiefer's Biographical Sketches of Memorable Christians of the Past, s.v. October 19: Henry Martyn:

"[Martyn's] diary has been called 'one of the most precious treasures of Anglican devotion.'"

Martyn, who died on this date in 1812 while on a missionary journey in Persia, was a gifted translator and one of the most energetic of Anglican missionaries. I know little about him beyond the short biography in Kiefer, which mirrors the one-page account in the Episcopal book "Lesser Feasts and Fasts." He appears to have been much influenced by another Anglican saint, Charles Simeon.

But hearing that line about his diary at Matins this morning made me curious: sure enough, it is available on Google Books.

It is a free PDF, or can be downloaded as an E-book. I have not looked at the e-book version, but I suspect it would be easier to read in the PDF version. It is unfortunately not available in Project Gutenberg, which is a superior source for free e-books.


If you are reading online, here is the excellent HTML version of both volumes at Project Canterbury.

I have so far done no more than spend fifteen minutes with the first pages of his diary. It is enough to show me that indeed it is a treasure, a very personal account of his spiritual life and struggles. I commend it to you, and to myself.

[added later] I read some more in Martyn's Journal over dinner. Do not be put off by the tenor of the first part, wherein he (to modern readers) seems overly grieved by his sinfulness and failures. I found it instructive to compare several months of the first year (1802) when he was still in England with passages from the end of his life (1811-12). On first acquaintance, he appears to have been a person for whom leisure was deadly - but when he could be fully engaged in the work of an evangelist, life was much better.

Another point of interest, once he reaches the mission field, is his accounts of learned conversations with the wise men that he met -- for Martyn was as skilled in mathematics and science as in religion and languages. These discussions roamed as freely among the natural sciences as among the fine points of Zoroastrianism and Islam as compared with Christianity.

From the entry for January 1, 1812:

To all appearance the present year will be more perilous than any I have seen, but if I live to complete the Persian New Testament, my life after that will be of less importance. But whether life or death be mine, may Christ be magnified in me. If he has work for me to do, I cannot die.

This sentiment appears to be utterly characteristic of Martyn, all the more so as he matured on the mission field. And it was a just assessment: he took a fever that autumn and died. Here are the final entries:

[from October 5]... I was pretty well lodged, and felt tolerably well till a little after sunset, when the ague came on with a violence I had never before experienced: I felt as if in a palsy; my teeth chattering, and my whole frame violently shaken. Aga Hosyn and another Persian, on their way here from Constantinople, going to Abbas Mirza, whom I had just before been visiting, came hastily to render me assistance if they could. These Persians appear quite brotherly after the Turks. While they pitied me, Hassan sat in perfect indifference, ruminating on the further delay this was likely to occasion. The cold fit, after continuing two or three hours, was followed by a fever, which lasted the whole night, and prevented sleep.

[October] 6. No horses being to be had, I had an unexpected repose. I sat in the orchard, and thought with sweet comfort and peace, of my God; in solitude my company, my friend, and comforter. Oh! when shall time give place to eternity? when shall appear that new heaven and new earth wherein dwelleth righteousness? There, there shall in no wise enter in any thing that defileth: none of that wickedness which has made men worse than wild beasts,--none of those corruptions which add still more to the miseries of mortality, shall be seen or heard of any more.

shutdowns and hunger games

For what it is worth, the local crisis center has put out a call for help: the W.I.C. ("Women, Infants, and Children") nutrition program is shut down along with other federal agencies and programmes. The word has gone out via e-mail to our church members, and doubtless at other local churches. There is a limit to what we can do.

A Huffington Post article about this, written when it was still a prospect for the future.

Locally, they are honoring WIC food vouchers that have already been issued, but no more can be issued until the budget impasse is solved. The situation varies somewhat from state to state, depending on whether a state might be willing or able to fund it temporarily to avoid starving children.

It is of such as this that revolutions are made.

[Added some weeks later... I won't link to it here, but a speech by one of the senators from North Dakota brought my attention to how things have been on the Native American Reservations since the "sequester" began earlier this year. Part of the U.S.'s treaty obligations to the Sioux and other tribes was that, since they were being shoehorned into reservations where they could no longer make a living in the traditional way, the U.S. government would see to it that they are fed, clothed, etc. The Bureau of Indian Affairs has always been chronically underfunded, but was cut even more by the sequester. Here is an analysis of its effect. At this writing, the "shutdown" has been temporarily resolved, but the "sequester" is looking more like a permanent fixture.]

commitment to the Song

With gracious thanks to M.W., who sent me a link to the excellent site The Daily Office from the Mission of St. Clare.

The site includes links to the BBC Choral Evensong, which is of course a staple of my life, as it has been for thousands of Anglicans these eighty years and more -- the longest running weekly radio broadcast that exists.

From Wikipedia, s.v. "BBC Radio 3":

The programme has a strong following, revealed by various unpopular attempts in the past to change the broadcast arrangements. When the programme was moved from Radio 4 to Radio 3 in 1970 it became a monthly broadcast but vigorous protests resulted in a return of the weekly transmission on Wednesday afternoons.

More recently, in 2007 the live broadcast was switched to Sundays which again resulted in protests. The live transmission was returned to Wednesdays in September 2008 with a recorded repeat on Sunday afternoons. Choral Evensong forms part of Radio 3's remit on religious programming though the musical performance and repertoire holds interest for a wider audience.

The Mission St. Clare site also includes links to Thursday Evensong at Grace Cathedral, San Francisco and Compline from St. Mark's, Seattle. This morning as I have worked through my e-mail and other deskwork, I have been listening to the Grace Cathedral broadcast and their excellent choir. For this service, the Canticles were Stanford in B flat, and the Anthem was Beati quorum via, likewise by Stanford - an appropriate choice for the feast, which was Eve of St. Francis.

The Grace Cathedral choir of men and boys is one of the finest in the world; the boys are in the Cathedral School, and the ATBs are all professional singers. Their singing of the Stanford music is splendid.

But it is, in one important way, inferior to what one would have heard at this year's RSCM Course (the Beati quorum via) and last year's (Stanford in B flat - I may be wrong about the year, but I know that we sang it very recently).

We were more committed to the music.

A choir such as Grace's sings this music all the time. Especially for the professionals, it can become commonplace: another day at the Office.

For those of us who attend an RSCM Course, it is anything but commonplace. This is our only opportunity all year to sing this sort of music, and with this sort of choir and director. For me, and I know for many others of us, these services, this music, are among the most important things in our lives. And that can be heard in the results.

I wrote of this some while ago about another time and place. We are, thank the Lord, not in the situation of those German musicians in 1944. For them, it really was life and death to play the Bruckner Ninth as what can only be termed a Prayer. But at whatever level one is making Music, it has a chance to be effective only when the musicians commit themselves entirely to what they are singing or playing.

As the Berlin Philharmonic showed in that recording, it is possible for professionals to achieve this. It is harder for them than it is for amateurs, and harder for adults than it is for children.

an interview with Wendell Berry

I commend to you this week's Bill Moyers webcast: an interview with Wendell Berry.

He speaks to many things that are important to me. Much of what he says has to do with the most important work a human can do: farming. That is not my task, so what am I to do?

It is hard to have hope. It is harder as you grow old, for hope must not depend on feeling good and there’s the dream of loneliness at absolute midnight. You also have withdrawn belief in the present reality of the future, which surely will surprise us, and hope is harder when it cannot come by prediction anymore than by wishing. But stop dithering. The young ask the old to hope. What will you tell them? Tell them at least what you say to yourself. Because we have not made our lives to fit our places, the forests are ruined, the fields, eroded, the streams polluted, the mountains, overturned. Hope then to belong to your place by your own knowledge of what it is that no other place is, and by your caring for it, as you care for no other place… This knowledge cannot be taken from you by power or by wealth. It will stop your ears to the powerful when they ask for your faith, and to the wealthy when they ask for your land and your work. … Be still and listen to the voices that belong to the stream banks and the trees and the open fields. … Find your hope, then, on the ground under your feet. Your hope of Heaven, let it rest on the ground underfoot…. The world is no better than its places. Its places at last are no better than their people while their people continue in them. When the people make dark the light within them, the world darkens.

"Hope then to belong to your place by your own knowledge of what it is that no other place is, and by your caring for it, as you care for no other place…"

For me, a church musician, it means to play our little old Pilcher organ in this parish, and to really listen to what it has to say, and to not care about the fine new instruments that might be in other places. It means to welcome university students when they come here to play their degree recitals. It means to pray Matins in our courtyard, or in the church, or in my office. It means to know the children and adults in our choirs and care about them, and to figure out how to help them grow. It means to listen to the congregation when they sing, and to do what I can to help them do it better.

Perhaps this is not as good as being attached to a piece of land, but it does, I think, mean belonging to my place, and knowing what there is about it that is true of no other place. And that is enough.

the Giving of Almes

Lay not up for yourselves treasures on earth.... (St. Matthew 6:19-21)

You can't take it with you. (proverbial saying: c.f. I Timothy 6:7)

But perhaps you can: I sometimes fancy that the treasures we will have in heaven are those things that we have given to the poor in this life. I think that C.S. Lewis said something similar about books: the only books in heaven are the ones that we loaned or gave away.

One of my regulars is the one-legged Marine that stakes out a busy intersection on my bicycle route to church. Yesterday was a home football game, and he was hard at work before dawn in order to catch the incoming fans, with his wheelchair decked with two American flags and a pennant for the local college team, and his artificial leg with the seal of the U.S. Marine Corps painted on the front of it. I always give him a little something.

We have become friends over the years from our brief encounters. I see him sometimes walking his dog in front of the cheap motel where he and his wife live, and visit with him for a few minutes. "I hate asking for money," he once told me. "And if it was just me, I wouldn't. But my wife needs her heart medicines."

We said our good-byes for the season yesterday, for my bicycle is going into winter storage this week and our paths do not cross when I ride the city bus. He told me that he and his wife have started going to church - not ours, but a storefront church closer where they live - and he wished God's blessings on me. I wish the same for him and his wife.

Then there is E., who caught me after church today at the Chinese restaurant. He came right in and sat across the table from me. "God sent me here," he told me, asking for $20 for a bus ticket. "I didn't know it for sure until I saw you through the window." Now, E. has been caught stealing from purses at the church. So I am not enthusiastic about helping him. And that $20 is more likely to go to drink than a bus ticket. But then again: "It's getting cold. And I can't get in the shelter here. If I go [sixty miles east, to the next town that has a homeless shelter], I think I can get in there." So maybe he will get on that bus. And how was I going to sit there, dressed in my fine white shirt, suit and tie, eating my fine dinner, with a man across the table from me telling me he was cold and hungry, and all this just seven days after hearing about Dives and Lazarus in last Sunday's Gospel?

And there is R., who went through a long struggle to get his SSI psychiatric disability - well-deserved in my opinion, for he is not remotely close to sanity. This week he lost his wallet, with his SSI card and all his cash, including his rent money. He has been by the church every day looking for me, and I have given him odds and ends - a partially-used transit bus pass, little bits of money. He wants five people who will each "loan" him $100; otherwise, they will evict him on Monday. I am not one of those people. But I gave him a little bit.

And there is D., another veteran, a drug addict. We helped him some; he tried to steal one of our chorister's leather jacket, and I suspect he stole another chorister's coat on another occasion, with wallet in the pocket (neither jacket nor thief were ever found). After talking with the VA people, I no longer give him cash. But when he comes by on a Sunday evening [not that often nowadays, but occasionally] and says he is hungry, I walk him across the street for a couple slices of pizza, and sit with him for a little. And pray with him. When I forget this last, he reminds me: "Aren't you going to say a prayer?"

And walking back to the church from the restaurant today, I saw a woman whom I had helped once this summer; she is mostly disabled (mentally as well as physically), and that day her motorized wheelchair ran out of juice, right in the middle of a busy intersection downtown. I was getting on the bus to go home, but no one was going to help her (the cars were blowing their horns at her, and driving around on both sides. None of the hundreds of university students who were busily going to their classes offered to help). So the two of us pushed her dead chair to her assisted living facility, going at the extremely slow pace at which she is able to walk. Today, I do not think that she recognized me, and I hurried across the street to avoid dealing with her.

For that is what happens. I want to lock the doors, go down in my basement office, and hide from these people.

The hard part about giving alms is that it is not just a one-time thing. If you give money to someone, most often they come back and ask for more. Again and again. For years. And you have to relate to these people as Children of God on an ongoing basis, even when you very much would rather not. It is easier to just write a check to Church World Service for people on the other side of the world, whom you will never encounter.

Some years ago, the parish had a system of "caregivers" who would interview the people who asked for help, connect them with social service agencies in the community, and screen out the drunkards and drug addicts, thus freeing the clergy from any direct interaction with the poor. [To be fair, one of our priests has always been involved with a weekly free breakfast for the poor, and rightly considers it central to her ministry. Blessings be upon her.] The "caregiver" program worked for a while, but all of the volunteers eventually burned out. After that, the policy was that our parish would no longer help anyone. If they came and asked for help, the staff was instructed to say (in essence): "Too bad. Go try the Crisis Center."

This was, in my view, a scandalous offense. How can we claim to be Christians and act this way?

As it happened, I had stopped donating to the parish around 2002, for reasons I would prefer not to describe. But "the tithe is the Lord's." Thus, I had a lot of money available. I gave most of it to places such as the Heifer Project, the Carter Center, Church World Service, the American Indian College Fund, and a couple of the local aid agencies. But I also had a fair amount of cash which I was willing to give to the poor, so I resolved to try and pick up the slack, so that the Name of Christ would not be blasphemed on account of our parish.

My situation is now different; I made a pledge to the parish for 2013, the first time in ten years, and thus I no longer have a lot of extra money for the poor. It is not yet a tithe, not even close, but it feels like a lot because there had been none, and I hope to increase it for 2014. And the parish does now help people as we are able.

But I still have these hangers-on. And I believe that I am at the least doing no harm in helping some of them in small ways; a few dollars here, a few there. I can now do no more without slighting the parish - on which I depend for my livelihood.

It is hard to set limits. The church staff helps, especially our office manager and the secretary, both of whom are also heavily involved in helping those who walk through our door.


I say all this not in any way to justify myself. I do not know if I have done any good for anyone. Maybe I am simply enabling their dependency, as the Republicans would say, and keeping them from taking responsibility for their lives. And very probably, my direct gifts do less good than would be done by donations to the local agencies, all of them starving for money and overflowing with people they cannot afford to help.

But we place ourselves in spiritual peril every time we harden our hearts and turn away from the poor man who seeks our assistance. Worse, we dishonor our Lord.

The only real answer is that of St. Francis: Give it ALL away, and yourself live as the poorest of the poor.

And I am not ready to do that.

----

Today was Evensong Sunday, the first Sunday of the month. In the month's rehearsals, the one Evensong amounts to as much choral rehearsal time as the four or five Sunday morning Eucharists all put together. It is similar for my organ playing; I try to play a larger work from the organ literature for the Evensong prelude, and it is about as much work as the voluntaries for the rest of the month's services.

The organ piece was the Priére by Cèsar Franck, an intense work of about thirteen or fourteen minutes' duration.

I played it seven years ago - badly, in spite of much work on it. This time, with my revised approach to organ practice, it went very well. I consider the improvement a validation of my practice method. I spent about eight hours over the course of about a week revising the fingerings, then did my careful work-throughs with slow repetitions of short passages, modified rhythms, and final review of each day's work by means of a slow play-through. All told, I was able to work through the piece at the organ only four times, over the space of about nine days -- and that was sufficient, even with almost no pre-service warmup on it this afternoon. I hope that this gives me more confidence in future work.

Obamacare and Me

Before Matins this morning, I turned on the computer and went to the official site for the Affordable Care Act.

When I saw their splashpage with the big title: "The Health Insurance Marketplace is Open!" I shed some tears. It has been a long time coming.

Many presidents, going back at least to Harry Truman, have sought affordable healthcare for Americans. Lyndon Johnson was the first to win a partial victory, by pushing Medicare through Congress. Harry Truman and his wife Bess were there when Johnson signed it into law in 1965, and were the first persons enrolled in the program.

That took care of the largest part of the issue: health care for persons over age 65. The rest should have been straightforward. It has not, however, proven easy. The debate over what became the Affordable Care Act (immediately labeled "Obamacare" by its detractors) is widely known, and I will not say more about it.

But it is perhaps worth a few minutes to relate how it affects me, a married person in his late fifties.

For a long time, I was a participant in the pension and healthcare plan of the Presbyterian Church (USA). Under their system (at least as it was in those days), the local church paid a fixed percentage of each employee's salary, which provided for a defined benefit pension and medical insurance. As they often said, it was a "community-based approach." Those who were well-paid (typically clergy) paid more, those who made less (typically lay employees, also clergy in smaller churches) paid less. All paid the same percentage, or rather the congregation paid on their behalf. It was (and remains) a thoroughly sensible approach.

Then I became an employee of the Episcopal Church.

Our diocese offers three medical insurance plans, and it is mandated by canon law that the local parish must pay the full cost of participation in these plans for the clergy. As it currently stands (2013), I may enroll in the insurance plan should I wish to do so. The cost for single-person coverage is about $9,000 a year; should I wish for my wife to also have insurance, the total cost would be slightly north of $20,000. The congregation would pay zero; it would all come out of my pocket -- which is not sufficiently deep for numbers like this.

Thus, my wife and I purchased individual coverage from the state Blue Cross/Blue Shield affiliate. We are on the cheapest plan they offer, which has such a limited list of coverages that it does not cover what the ACA calls "essential health services." We are both in excellent health, but have had "pre-existing conditions" ruled out -- for me, there was no coverage for anything related to the eyes, because I am sufficiently nearsighted to be at high risk for retinal detachment. The deductible for this policy is $11,000 a year -- that much has to be spent in medical bills before the plan pays so much as a penny. The premium is about $500 a month, covering the two of us; this premium has approximately tripled during the twelve years that we have had the policy. This is a "high deductible health savings plan" and is accompanied by a Health Savings Account, to which we can make tax-free contributions, and we have done so every year, right up to the maximum allowed. This money sits in a HSA earning about 0.5% interest with a $25 annual fee eating away at it.

In my opinion, this is not a satisfactory arrangement. But it is the best we can do, balancing affordability with at least a minimum of insurance -- for, if you are uninsured in America, you are one accident or illness away from bankruptcy.

Correction: you WERE one accident away from bankruptcy. Today, that all changed.


I spent only a few minutes on the HealthCare.gov website; it is a busy day for them and their servers are maxed out. I downloaded a form that my employer will need to fill out, which is part of my proof that I cannot afford the insurance offered by my employer (it is well over the 9.5% of family income that is the cutoff). Our income falls easily within the range that should make us eligible for a subsidy on our premium payments. It looks promising; the best I can tell, we should be able to find coverage in the "Marketplace" and get by for no more than we currently pay, and receive much better coverage.

"Obamacare" is a term of derision coined by the program's detractors -- there are some deep-pocketed people out there who have funded a sophisticated program of dis-information about the law, and at this writing, the Republicans in Congress remain determined to kill the program. I use the term in the hope that "Obamacare" becomes a badge of honor for this president, who has staked everything on it. I believe that it will do as much to benefit the ordinary people of the U.S. as Social Security.

At the least, this American, who on the whole is not a fan of President Obama, wishes to thank him for bringing us to this day. My hat is off to you, Mr. President.

[I tip my hat also to Sen. Edward Kennedy, of blessed memory, for whom this was an issue of utmost importance. And Pres. Richard Nixon, who was among those who tried and failed to bring universal health care to Americans. His proposals back in the 1970's, built around a mandate for employer-provided insurance, have many likenesses to the Affordable Care Act as it now stands.]