Dan Savage reacts to the announcement that the ACA hit its enrollment target of 7 million:
Great news! And Republicans—who will never offer a Republican alternative health-care plan and who will never acknowledge that Obamacare used to be the Republican alternative to the kind of single-payer health care plan preferred by liberals, progressives, and sane countries everywhere (countries like Canada, Germany, France, Israel, and Vatican City)—are gnashing their teeth.
Chait details how that GOP intransigence reveals a deeper divide between the parties:
One of my longstanding fixations, going back almost a decade now, is that we make a mistake when we think of liberalism and conservative as symmetric ways of thinking. On economic policy, at least, they are asymmetric. Liberals believe in activist government entirely as a means to various ends. Pollution controls are useful only insofar as they result in cleaner air; national health insurance is valuable only to the extent that it helps people obtain medical care. More spending and more regulation are not ends in and of themselves. Conservatives, on the other hand, believe in small government not only for practical reasons — this program will cost too much or fail to work — but for philosophical reasons as well.
A new political science paper by Matt Grossman and David Hopkins bears out this way of thinking about American politics. The authors find a fundamental asymmetry between the Republican and Democratic coalitions. They examined survey results and other data among voters, activists, and elites, and found that Republicans express their beliefs about government as abstract ideology (big government is bad) while Democrats express their beliefs in the form of benefits for groups. The differences are enormous [as the above chart from the paper demonstrates.]
This, he argues, is why Republicans “have expressed from the beginning a theological certainty that Obamacare will fail.” Steinglass also tries to understand ACA opposition:
For the most part … opposition to Obamacare now is based on two things.
At one level, it’s a question of partisanship. Republicans have turned “Obamacare” into a word that much of the country finds inherently distasteful. No matter how well the system performs, it’s too late to reverse those associations. At another level, many dislike the basic transaction at the heart of universal coverage: richer people have to basically pay for poorer people’s health-insurance. In Kentucky, for example, Republicans are avidly working to reverse the state’s Medicaid expansion, even though the federal government pays for the entire thing initially, with the state expected to kick in 10% in the future.
Ponnuru, yet again, calls for conservatives to stop awaiting the ACA’s failure:
The likelihood of replacement would be higher if there was an alternative that didn’t take away people’s insurance — one that promised to cover roughly as many people as Obamacare does, or even more. Letting people on Medicaid buy into the market by converting much of the program into tax credits, for example, would be more viable than just kicking its new beneficiaries off the rolls. Opponents of Obamacare should always have been thinking along these lines. Now they have less and less choice.
The Dish 