On August 15, 2011, President Barack Obama made a fairly routine campaign stop in Cannon Falls, Minnesota. It was the first stop of a road trip through several midwestern cities in the early days of the 2012 election, and Obama’s approval rating had dipped to 40 percent, the lowest of his presidency to date.
It was during his answer to a question about the rising cost of prescription drugs that something a bit unexpected happened.
“Part of the Affordable Care Act, health care reform, also known as Obamacare—by the way, let me tell you, I have no problem with folks saying Obama cares,” he said, to applause. “I do care. If the other side wants to be the folks who don’t care, that’s fine with me.”
It marked the first time Obama appeared to publicly embrace the term “Obamacare” to refer to his signature health care law. In the years since, he and his supporters have completely co-opted the word, transmogrifying it from a term of derision employed by Republicans hoping to undermine both the law and the president into a term of endearment that will forever be a part of Obama’s legacy — perhaps even if it ends up getting repealed.
“Obamacare” is certainly not unique among political eponyms. Reaganomics, Bushisms, Nixonian: all remain in wide circulation. Specifically, health care portmanteaus predate Obama by decades. During Bill Clinton’s presidency, Hillary’s attempts to reform health care were dubbed Hillarycare, a term that followed her through both of her presidential campaigns.
“Obamacare” can be traced back to an article from the March 2007 issue of Healthcare Financial Management written by Jeanne Schulte Scott, a health care industry lobbyist who affixed the ‘-care’ suffix to the names of several candidates running for president in 2008.
“We will soon see a ‘Giuliani-care’ and ‘Obama-care’ to go along with ‘McCain-care’, ‘Edwards-care’, and a totally revamped and remodeled ‘Hillary-care’ from the 1990s,” she wrote.
But the term “Obamacare” proliferated thanks to congressional Republicans who, sensing an opportunity to torpedo the Obama administration by attaching his name to a piece of legislation they were sure was bound to fail, began using it ad nauseam. On July 8, 2009, Sen. Roy Blunt (R-MO) formally entered the word into the congressional record for the first time, quoting from an op-ed published the day before in the Wall Street Journal. Within the year, “Obamacare” was on the lips of every Republican in Congress, and by the summer of 2012, the word had been officially logged in campaign speeches nearly 3,000 times, according to an analysis by the Sunlight Foundation.
“The use of the term ‘Obamacare’ was part of the Republicans’ strategy to delegitimize the president.”
“The whole point is to make the person own the policy,” said Dr. Martin Medhurst, a distinguished professor of rhetoric and communication at Baylor University in Texas. “That is exactly what the Republicans did, they could then link it to a lot of the negative connotations that people had of President Obama.”
Stephen Farnsworth, the director of the Center for Leadership and Media Studies at the University of Mary Washington, agrees. “The use of the term ‘Obamacare’ was part of the Republicans’ strategy to delegitimize the president,” he told ThinkProgress. It was a strategy pushed by Republican pollster Frank Luntz and others in the early days of the health care debate.
“I never thought it would stick,” Luntz told the New York Times in 2012. “People want health care personalized, not politicized, and the phrase Obamacare is an effective way to communicate the politicization of health care.”
The fact that Republicans had seized upon the term as a pejorative directed at President Obama did not sit well with Democrats in Congress. In early 2011, Rep. Debbie Wasserman Schultz (D-FL) lodged a formal complaint on the House floor against the use of the word, suggesting its disparaging nature was in violation of House rules.
But by that fall, with the primaries underway and Republicans keen on ousting Obama in 2012, the use of the term only grew — eventually spawning its own equally derisive spinoffs targeted at fellow Republicans (Obamneycare, anyone?).
Running against Obamacare proved to be an effective strategy during the 2010 midterms as well. “‘Obamacare’ was a useful device to help elect Republicans,” said Farnsworth, who wrote the book Spinner in Chief: How Presidents Sell Their Policies and Themselves. “It served its purpose for Republicans. But it also served its purpose for Democrats.”
In March of 2012, with many key provisions of the law already implemented, the Obama campaign began using the term on social media, urging supporters to share their stories about why they liked Obamacare. That summer, Obama continued to toy with the term during his stump speech, breaking it down into “Obama cares” and reiterating that yes, he does in fact care about Americans’ access to insurance. That June, after the Supreme Court upheld the most controversial component of the law—the federal mandate that requires all Americans to purchase insurance— supporters of the bill celebrated on the steps of the building waving signs that read “I Love Obamacare.” On Obama’s campaign website, his supporters could buy a bumper sticker or t-shirt reading “I Like Obamacare.”
“Barack Obama was very wise to adapt the term ‘Obamacare’ as his own,” said Farnsworth. “It is a painful rule of politics: fight the framing with your own framing or you are going to lose the debate.”
And according to former White House Communications Director Dan Pfeiffer, it was indeed Obama who jump-started efforts to reclaim the word. “We describe health reform in many ways but we certainly don’t run from the term Obamacare,” he said at the time.
“It is a painful rule of politics: fight the framing with your own framing or you are going to lose the debate.”
Which means that Republicans may have unwittingly secured the single biggest victory for President Obama’s legacy.
“I’m convinced at the end of the decade, the Republicans are going to regret turning this [into] ‘Obamacare,’” David Plouffe, Obama’s former campaign manager and senior advisor, told CBS in 2012. As Obama himself joked in 2014, now that the law is working, it will be Republicans who are going to want to change the name.
None of that has swayed Republicans, who have been singularly fixated on repealing the law since the moment Obama signed on the dotted line in March 2010. Now that Republicans have control of every branch of government, they’re eager to move forward with dismantling the law itself. But undoing the legacy they helped create—by enshrining an imperfect but nevertheless incredibly beneficial health care system with the name of its creator—is going to be much more difficult.
“If the Republicans succeed in their efforts to repeal Obamacare, people will miss it when it’s gone,” said Farnsworth. “The best way to increase support for Obamacare is to take it away.”
For evidence of this in action, turn to this viral image that circulated widely on Reddit this week. An unnamed conservative on Facebook was cheering a vote by Republicans to do away with Obamacare, thankful that his own insurance remained untouched. There’s just one problem.
“I’m not on Obamacare. My health insurance is through the ACA (Affordable Care Act), which was what they had to come up with after Obamacare crashed and burned as bad as it did,” the anonymous user wrote. “So I’m gonna be fine.”