President Trump last week pressured Republicans to repeal and replace the Affordable Care Act. If they didn’t, he warned, they would lose their seats in the next election. Speaker Paul D. Ryan ultimately withdrew the bill, where seven years prior, on the same House floor, I voted to pass the Affordable Care Act into law.

In 2010, as a freshman congressman, I stared down the same threats that many Republican representatives face today, and I had to balance what I thought was right versus what I knew was politically advantageous. I was a Democrat representing a red Virginia district. Back then, a vote backing the Affordable Care Act — which Republican strategists had already branded “Obamacare” — meant facing millions of dollars in right-wing attack ads and almost certain defeat at the polls that fall.

My critics were right: I did lose my seat. But I never regretted my vote. Not once.

Since then, hundreds of Americans have reached out to tell me how the ACA has helped them personally: parents who obtained life-saving treatment for their adult children because they were able to keep them on their insurance plans; workers who left dead-end jobs to pursue their dreams, secure in the knowledge that they could buy insurance on newly created exchanges.


In voting to pass the ACA, I made a long-term bet that it would save lives well worth the short-term political costs.

It may sound cheesy in this polarized, chaotic and cynical political moment, but public office is not about doing what’s easy. It’s about service. In voting to pass the ACA, I made a long-term bet that it would save lives well worth the short-term political costs.

My father, Vito, practiced as a pediatrician in Charlottesville, Va., for more than 35 years. During the 1994 healthcare debate, he opposed the Clinton administration’s proposed reforms. Then he spent years bemoaning the status quo. He said businesses and insurance companies were making all the decisions and getting in his way.

In early 2009, in one of my final conversations with him before he died suddenly, he shared his hope that President Obama would dare to tackle healthcare reform again. A year later, I wore one of my father’s old suits to cast my vote to ensure that every American had access to affordable, quality health insurance.


The ACA was not perfect, but it made coverage available to 49,000 residents of my district and ensured that every constituent who already had private insurance would no longer face lifetime or annual caps on coverage. Mental health coverage and maternity and postnatal care would be guaranteed, along with universal access to contraception.

During the contentious healthcare debate, I held more than 23 town hall meetings, in every county of my district. More than 18,000 Virginians attended these events. Thousands more dialed in to participate in conference calls. Most constituents at these meetings had already decided whether or not to support the Affordable Care Act. Many of them were angry. I was literally spit on and verbally berated regularly, but still always respected the rights of conservative constituents to face me unfiltered.

It really puzzles me when I see Republicans dodging their constituents over the now-abandoned American Health Care Act or any one of Trump’s extremist policies. Who do you think your boss is, The Donald or your constituents? Showing up and listening is the bare minimum.


Since we passed the ACA, nearly 400,000 Virginians have signed up to purchase private insurance through the health insurance marketplace. I am one of them. Our challenges today often require solutions that will not take root before the next election cycle. That means they only get solved if politicians accept near-term political suffering — which, let’s be honest, is nothing in comparison to what a parent without insurance endured under our previous system.

Although this repeal-and-replace bill failed, there will be other attacks on the ACA. Trump will continue his threats to roll back its progress and take health insurance away from 18 million Americans. There will be more difficult choices ahead of us. For those in federal and local government considering how to respond, I can attest that the handshakes and hugs from thankful parents over the years have meant far more to me than a couple more years in Congress ever would.

Tom Perriello, a Democrat, represented Virginia’s 5th District in the U.S. House from 2009 to 2011. He is running for governor of Virginia.

Follow the Opinion section on Twitter @latimesopinion or Facebook


MORE FROM OPINION

Are we subsidizing a public health crisis by allowing the poor to buy soda with food stamps?

Trump’s public broadcasting cuts will zero out live, local, real news

How do you train the next generation of journalists to deal with Trump’s America?