Obamacare’s successes create problems for Republicans


The Republican party’s determination to repeal, or at least undermine, the Affordable Care Act (aka Obamacare) by throwing roadblocks in its path was obviously predicated on their fear, not that it would fail, but that it would succeed. They rightly guessed that despite its clunky structure and its pro-health care industry tilt, if it succeeded in providing health care access to large numbers of people at a reasonable cost, then it would become harder to get rid of the program. So it had to be stopped early.

As a result we saw repeated frantic attempts at repealing it in Congress, states refusing to set up their own exchanges or expand Medicaid eligibility, legal challenges on this or that feature of the legislation, and scare tactics aimed at discouraging people, especially the young, from signing up.

It is clear from the data that that strategy has failed. Despite the disastrous initial rollout of the federal health exchanges, not only have enrollments exceeded expectations, the cost savings for the future are also better than anticipated. Republican alarms that the lower premium costs in the first year were kind of a loss-leader and that premiums would skyrocket in future years have also turned out to be unfounded. Now 74% of Republicans who enrolled in the program say that they are either satisfied or very satisfied with their coverage.

As Jonathan Chait says:

As the law shocked detractors last spring by exceeding its enrollment targets, the anti-Obamacare community fixated on a final hope: that consumers looking to enroll this fall for next year would encounter soaring premiums. Not only has the hoped-for premium shock failed to materialize, rates seem to be coming in actually lower than this year. In a market where annual large price hikes have occurred for decades, the result is almost unfathomably positive.

This issue was supposed to be the galvanizing one that would provide the energy for the wave election that would sweep Republicans into office in November and the party is scrambling to revamp its message but cannot seem to agree on what it should be, with some shifting in favor of implementing some aspects of the law.

Unpopular Pennsylvania Republican Governor Tom Corbett recently agreed to accept Medicaid expansion. Four more Republican governors — in Tennessee, Utah, Indiana, and Wyoming — have taken steps toward following suit. In Washington, the river of attacks against Obamacare issuing from Republicans has slowed to a trickle. (The number of Congressional news releases attacking the law has fallen by 75 percent this summer from last.) The Weekly Standard’s Jeffrey Anderson is warning darkly of an “anti-repeal wing” within the party. “Root and branch repeal is starting to look more like twig and leaf,” concedes Reason’s Peter Suderman.

The last slim hope is the ongoing legal challenge that argues that the literal wording of the law prevents the federal exchanges from stepping in to provide subsidies in states that decided against setting up their own exchanges. A three-judge panel of the DC Circuit Court of Appeals ruled 2-1 in the summer that those federal exchange subsidies violated the letter of the ACA and struck them down. The full court of the DC Circuit Court of Appeals decided to review that verdict and is due to hear that case. If they reverse and uphold the federal subsidies, then the last major challenge will be over, unless the US Supreme Court agrees to hear the case. But by the time they weigh in, it will be 2016 at the least when the program will be even more entrenched and leaves Republicans with the problem of what to do in the 2016 elections.

Chait continues looks at how Republicans are reacting.

The Republican crusade against Obamacare is not ending; rather, it is shrinking and mutating. The party base will demand a presidential nominee who promises to repeal the hated law, just as it did in 2012. But the next Republican candidate will be running in an environment where repealing the law would create millions and millions of now-identifiable victims. Since the start of the year, Obamacare has gone from a weakness Republicans were salivating at the chance to exploit to an issue they no longer want to talk about. Two years from now, matters could be worse still.

Some Republican politicians are still saying that they will vote to repeal Obamacare if they get control of the Senate but this seems more like face-saving rhetoric. They have not produced an alternative plan despite repeated promises to do so and they know that president Obama would veto a repeal bill anyway. The only scenario under which Obamacare will be repealed is if Republicans take control of the White House, Senate and House of Representatives.

Comments

  1. says

    They have not produced an alternative plan despite repeated promises to do so and they know that president Obama would veto a repeal bill anyway

    That’s partly b/c the ACA was the Republican alternative to any Democratic health care reform plan. Since Obama took it over from Romney and made it his plan, what else do they have?

  2. AsqJames says

    Based on the evolution of Tory messaging on the NHS, I predict the initial position of “opposing” passing the ACA, which moved quickly to “blocking” its implementation and then to “repealing” it, will eventually morph into claiming to support it while calling for “reform”. They won’t explicitly spell it out (except in rare unguarded moments), but the “reforms” they’ll want to implement (in order to “modernise” the law) will have the effect of gutting it.

    “Every generation must fight the same battles again and again. There’s no final victory and there’s no final defeat” – Tony Benn.

    The battle for civil and voting rights was not over when the Civil Rights Act and the Voting Rights Act passed, nor after subsequent Congresses and Presidents re-affirmed those laws. The tactics and the rhetoric have changed, but the ground is still disputed. It probably always will be.

    “The NHS will last as long as there are folk left with the faith to fight for it” – Nye Bevan

    As you demonstrate Mano, the fight for the ACA was clearly not over with its passage, and will not be over after the mid-terms in November, nor after the Presidential election in 2016. It probably always will be.

  3. Chiroptera says

    AsqJames, #1: They won’t explicitly spell it out (except in rare unguarded moments), but the “reforms” they’ll want to implement (in order to “modernise” the law) will have the effect of gutting it.

    Case in point: this is exactly what they’ve been trying to do with Social Security.

  4. Holms says

    Was the rollout so bad? From what I saw from afar, it seemed buggy and slow but otherwise functional; far from disastrous.

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