Obamacare for real
In late September the right wing of the House of Representatives was attempting to force a government shutdown. Whether or not it succeeds, more brinksmanship looms: a vote on raising the debt ceiling is just weeks away, and Republican hard-liners promise another fight over that. The GOP leadership doesn’t want any of this, but the leadership has tenuous control over its caucus.
The hard-liners’ beef is with Obamacare. Several representatives have joined Sen. Ted Cruz (R., Texas) in insisting that the health-care reform law is so misguided and unworkable—its threat to Americans so great—that desperate measures are required. So they’ll agree to fund government operations or raise the debt ceiling only if Obamacare is stripped of funding.
This stance defies logic. If the reform law is so flawed, why not try to make it better? Why not wait till the law takes full effect and its failure becomes obvious, at which point it could be repealed through less destructive means—without endangering the entire economy?
Cruz revealed his answer to that question this summer in a candid moment on Fox News: “If we’re going to repeal [the law], we’ve got to do so now,” because once it takes effect Americans will get “hooked on Obamacare.” In other words, opponents aren’t worried that reform won’t work as planned—they’re worried that it will and that it will become as popular as Social Security. For those who oppose social spending on principle, this is an alarming possibility.
Obamacare is a deficit-reducing set of market-based reforms, modeled largely on Republican ideas. But it does involve spending public money to make sure low- and middle-income Americans have health insurance. Some lawmakers see this role for government as categorically a bad thing.
This is the same ideology that led the House to pass massive cuts to food stamps not because the program doesn’t accomplish its goal of feeding hungry people—it does, and pretty efficiently—but because some legislators object to the government’s spending money to feed hungry people.
Voters overwhelmingly oppose House Republicans’ effort to shut down the government over Obamacare, but the party’s base is deeply opposed to the health-care law. While party leaders feel compelled to participate in real governance, individual members have a greater incentive to fight Obamacare tooth and nail. It’s a serious intra-party problem.
It’s also a problem of the right’s own making. Negative public perception of reform has been driven by a disinformation campaign that portrays Obamacare as a government takeover of health care and a threat to freedom. In reality, the law is aimed mostly at getting more Americans insured and requiring insurers to treat people better.
The law’s primary provisions are finally taking effect. The exchanges (online insurance marketplaces) open this month, and in January the expansion of Medicaid will take place and discrimination against patients with preexisting conditions will be eliminated.
Doubtless Obamacare will have hiccups, with adjustments needed. But it will be very difficult to repeal if it makes Americans’ lives better—which is what Cruz and his allies fear.