Obamacare and the Arc of Conservative Wishful Thinking
Posted on June 24, 2013
In just over three months, you’ll be able to sign up for coverage in health insurance exchanges. Well, maybe.
The GAO recently found that the Administration is way behind schedule in standing up the exchanges. Worse still, it appears that fewer insurers than hoped will be offering coverage. And the New York Times has reported on the problems that the new law is presenting for clinics that serve people with low incomes.
So, other than maybe lacking health insurance marketplaces, insurance companies with plans to market and enough doctors to care for newly insured people, Obamacare implementation is going just fine.
Which suits many conservatives just fine. But I’m not so sure that standing back and hoping the law’s implementation falls flat will prove an effective strategy.
At the heart of this strategy is the notion embedded in the conservative psyche that the law lacks legitimacy. Conservatives have criticized the exclusion of Republicans from writing the bill, the deals the White House cut with health care lobbyists, and the sweeteners infused into the bill to procure 60 Senate votes to show that it was sketchy from the start. They have challenged the law’s constitutionality and encouraged states to resist its implementation. The law lacks legitimacy, they reason, and is therefore bound to fall.
They’ve thought that before, though. Obamacare has survived a series of near-death experiences: Scott Brown’s election, Democrats’ disastrous 2010 elections, a Supreme Court challenge, the 2012 Presidential election, and the refusal of some states to expand Medicaid or create exchanges. Through it all, its implementation has limped on.
Now the arc of conservative wishful thinking reaches its endpoint. Having seen all previous efforts to derail the law fail, this hope only remains: that the law, once implemented, will fall of its own weight.
This hope, I fear, will prove illusory. Implementation will make the law’s problems apparent, but won’t lead to its repeal. There are many reasons for this, but the most important one is that the law will benefit some people. Cancer survivors who couldn’t get insurance will find coverage. The chronically unemployed – and there are lots of them — will find government-subsidized health insurance more affordable. You can’t spend $1.8 trillion without helping somebody. And those stories, alongside tales of the law’s failings, will reverberate throughout the mainstream and social media. “It’s a stupid law,” people will say, “but at least Uncle Joe got health insurance.”
It is, of course, possible that the present scandals or some unforeseen event will weaken the President’s popularity to the point that problems with the law’s implementation will become his Hurricane Katrina. Loss of public faith in his competence could cause erosion of support within his own party, forcing him to agree to a substantial rewrite of the law. But that possibility strikes me as remote.
Obamacare, regrettably, will likely survive this latest round of conservative wishful thinking.
Doug Badger is a former partner in The Nickles Group, a lobbying firm. Prior to that, he was Deputy Assistant for Legislative Affairs to President George W. Bush. He helped develop President Bush’s proposal for a Medicare prescription drug benefit and health savings accounts. He has also served as Chief of Staff to the Senate Republican Whip and to the Republican Policy Committee and held senior positions at HHS and the Social Security Administration. He has recently retired and lives with his wife, Debbie, in Ashburn, VA, where he writes a blog called Doug's Brief Case.