Obama’s Big Health Care Win: An Incredible Stroke of Luck

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David Goldman / AP

Supporters of President Obama's health care law celebrate outside the Supreme Court in Washington on June 28, 2012, after the court announced its ruling

During the Tea Party summer of 2009, when suburban revolutionaries with funny hats and nasty signs began screaming about Obamacare and tyranny, chief of staff Rahm Emanuel urged the President to settle for a less comprehensive health plan. But Obama said no, he felt lucky. At the end of the summer, after Obama’s approval ratings had sagged and Obamacare’s approval ratings had plunged, Emanuel asked during an Oval Office meeting whether he still felt lucky.

“My name is Barack Hussein Obama and I’m sitting here,” said Obama, in an anecdote first reported by Jonathan Alter in his book The Promise. “So yeah, I’m feeling pretty lucky.”

Today, Obama must be feeling even luckier. Obamacare has survived, thanks to Chief Justice John Roberts, a conservative George W. Bush appointee who surprised legal pundits by upholding the plan’s insurance requirement as a tax, even though Obama always insisted it wasn’t a tax. The other four conservative Justices wanted to strike down the entire law, but because one Republican in a robe defied expectations, Obama has secured an achievement that Democrats have dreamed of since FDR and Truman, extending health insurance to the uninsured, while laying the groundwork for systemic reforms. As Vice President Joe Biden said, it’s a big you-know-what deal.

(MORE: The Supreme Court’s Health Care Ruling: The Winners and Losers)

And as the Duke of Wellington once said, it was a near run thing.

It’s worth recalling just how narrow a needle Obama had to thread to get his health plan to this point. During the 2008 campaign, Obama had criticized the individual mandate, arguing that the real problem with health care was that it was too expensive, and that the path to universal coverage was to make it cheaper. But when he decided to push for health reform in the spring of 2009, he discovered that Senate Finance Committee chairman Max Baucus, a centrist Democrat who took the lead on reform, thought a mandate was the only path to a filibuster-proof majority. So the White House let Baucus pursue a bipartisan solution.

Do you remember how the pressure mounted that spring and summer, as the Tea Party exploded, Republicans began attacking Obamacare as an assault on liberty, Sarah Palin began warning of “death panels,” and even Baucus’ close friend and primary negotiating partner, Senator Chuck Grassley of Iowa, accused the President of trying to pull the plug on Grandma? Emanuel was screaming at Baucus to hurry up and deliver a bill, but Baucus felt like he needed to make every effort to reach out to Republicans — not just to try to pick off a few GOP votes but also to appease red-state Democrats who didn’t want a partisan bill. So he slow-walked the bill, and the Fox News drumbeat kept getting louder, and the polls kept getting uglier.

(MORE: Supreme Court Hands Obama a Political Win)

Ultimately, it became clear that Republicans weren’t going to play, which meant Obama and Baucus needed the votes of every one of the 58 Democrats and two independents in the Senate. If Democrat Al Franken of Minnesota hadn’t been seated after winning a lengthy recount by a handful of votes, no Obamacare. If Arlen Specter hadn’t switched to the Democratic Party after his vote for Obama’s stimulus doomed his chances in a Tea Party-dominated GOP primary, no Obamacare. If Emanuel hadn’t cut backroom deals for individual Senators — the “Cornhusker Kickback” for Ben Nelson of Nebraska, the “Louisiana Purchase” for Mary Landrieu of Louisiana — no Obamacare. If Obama had insisted on including the “public option” beloved by liberals but anathema to independent Joe Lieberman of Connecticut, no Obamacare. If centrists like Evan Bayh of Indiana or Blanche Lincoln of Arkansas had decided that the President and Baucus hadn’t made enough of an effort to bring in Republicans, no Obamacare.

And then, after the House and Senate finally managed to pass comprehensive reforms before the Christmas holiday, but before the two bills could be reconciled into a final compromise legislation, an unknown Massachusetts Republican named Scott Brown won a stunning upset to claim the late Ted Kennedy’s Senate seat, upending the filibuster-proof Democratic majority. It looked like Obamacare was dead after all. House and Senate Democrats were at one another’s throats, drowning in recriminations. Again, Emanuel pushed Obama to cut a deal for a modest bill rather than destroy his presidency in an ignominious defeat. Again, Obama felt lucky.

(MORE: How the Supreme Court Rose Above Partisan Politics)

The President barely mentioned health care in his 2010 State of the Union address. But somehow, he got the bill across the finish line. There was yet another hiccup near the end over abortion, but the White House worked out a deal that kept pro-life House Democrats on board. And with some legislative legerdemain, the House passed the Senate bill, so Obama no longer needed 60 votes, and the Senate approved some tweaks that didn’t require 60 votes, as well as a sweeping student-loan reform that had to be included for reasons I don’t even remember right now.

Most legal scholars scoffed at the notion that the Supreme Court might find the law unconstitutional, but it turned out to be a very serious threat. Just the other day, an Obama campaign operative told me the White House seemed blithely confident that the court would uphold the bill, that Obama didn’t seem to have a Plan B. “They seem to think it’s going to be fine,” he said in a tone of voice that didn’t suggest he thought it was going to be fine.

It turned out that they were right. Without a single vote to spare in the court, the same margin it had in Congress, Obamacare survived. Barack Hussein Obama is a lucky guy. And today, 32 million uninsured Americans are sharing his good fortune.

SPECIAL: TIME’s Complete Coverage of the Affordable Care Act