What If Obamacare Works?

Chait’s article on Republican opposition to Obamacare is worth a read. What it clarifies for me is something quite simple. There’s absolutely a role for an aggressive opposition to any large new initiative like this. At the same time, we live in a constitutional system which Sen. Ted Cruz Speaks Before A "Defund Obamacare" Town Hallrequires adherence to some simple norms. The first is that a general election, especially when an issue is front-and-center in it, should count. Two general elections should count as well. Obama has been elected and re-elected on a specific pledge to bring both cost discipline to the healthcare sector (now hugely more inefficient compared with others in the world) and to expand coverage to as close to universal as is feasible. The legislative maneuvering for it was messy; and the roll-out of such a plan is bound to have glitches and surprises.

The opposition could use weaknesses in the law to propose fixes; it could urge for a more radical severing of employment with insurance; it could fight for more effective and competitive healthcare exchanges; it should keep an eagle eye on cost over-runs. But if it only controls the House, it should not stop already-passed legislation from being implemented out of partisan spite or ideological zeal. It should not threaten the very functioning of all government or a credit crisis to stop something that cannot – and should not – be constitutionally stopped. That’s not opposition; it’s sabotage – especially the campaign to get young people not to opt in. It is a form of nihilist vandalism, based, as Chait carefully explains, on a whole slew of contradictions, fantasies and alternative universes.

Chait’s worried – but not too worried – about the effects of this unprecedented and anti-constitutional campaign:

It is hard to imagine that the news about Obamacare over the next few months will be good. The rollout of Medicare, and the addition of prescription-drug coverage under George W. Bush, both provoked mass confusion and complaint, and those laws were not fighting off an angry rearguard insurgency. The question is whether the glitches and failures amount, in either reality or perception, to the sort of catastrophic failure that leads panicked insurance companies, potential customers, governors, and state legislatures to pull out.

Conservatives have portrayed their war against the exchanges as a desperate last stand against Obamacare and for freedom as we know it. History is replete with previous examples of last stands. Ronald Reagan warned conservatives in 1961 that if Medicare passed into law, “one of these days you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.” The conservative movement sustains itself by constantly disregarding its warnings of the last mortal threat to liberty and redirecting itself onto the next one. Yet it has made opposition to Obamacare completely central to its identity. If the Obamacare train does not wreck—or, to put it more accurately, if conservatives fail to wreck the train—it will be fascinating to see: What will they do next?

Drum sizes up the politics of Obamacare sabotage:

Given the tiny percentage of non-tea-partiers who approve of the deliberate sabotage strategy, a scorched-earth campaign by Republicans could backfire on them pretty badly. It all depends on how well the rollout of Obamacare goes, and how that affects public opinion. That makes the next few months pretty critical for both sides. If the rollout is relatively smooth, support for Obamacare will rise—especially among the people who benefit from it, many of whom are still skeptical that it’s for real. But if the Fox News crowd manages to convince the public that every minor problem represents an epic disaster unfolding in front of their eyes, then who knows? Maybe the sabotage strategy will pan out.

Waldman’s view:

[C]ome January, the ACA will be transformed. It will no longer be a big, abstract entity that would be possible to undo. Instead, it will be what it truly was all along: a large number of specific reforms and regulations that in practical terms are entirely separate from one another. What this means is that once it takes effect, “Obamacare” for all intents and purposes will cease to exist.

It’s always easier to oppose an abstraction than a reality. We saw that with marriage equality. Maybe the opposition to Obamacare will fade away as fast as opposition to gay equality. Because it is based on the same ignorance, panic and fear.

(Photo: Sen. Ted Cruz  speaks during a town hall meeting hosted by Heritage Action For America at the Hilton Anatole on August 20, 2013 in Dallas, Texas. Cruz is staging events across Texas sharing his plan to defund U.S. President Barack Obama’s Affordable Care Act. By Brandon Wade/Getty Images.)