No, Obamacare will not “fail” if we just get out of the way

Now that the anti-Obamacare defund “strategy” (such as it was) has been tried and failed, many on the right are suggesting we get out of the way and let it be implemented in full, on time, as written, so that it can be allowed to fail on its own. The theory is that when it doesn’t work, runs out of money, and breaks the insurance system, the public will demand its repeal just in time for a Republican president to be elected in 2016 and do just that. This, like “repeal and replace” and defund before it, is an unwise and short-sighted strategy.

What precedent is there for a government program, especially an entitlement, failing and just ending? Social Security is out of money, but no one will touch it. Medicare is out of money, Obamacare cut doctor payments rates under it, but no one will dare to truly reform it. Welfare was reformed, not ended or repealed, in the 1990s. Food stamps have exploded. Medicaid doesn’t work either, but was expanded under Obamacare. But we somehow think that if Obamacare runs out of money or doesn’t work as well as it was intended, it will just go away, unlike every other program ever?

No, Obamacare is not going away, unfortunately. Based on the scant evidence of only every other government program for the last 100 years, we will always have health insurance exchanges, federal coverage mandates, premium subsidies, and expanded Medicaid. But we can make them less terrible and maybe get rid of some of the more terrible parts. There is plenty of opportunity for incremental reform to at least make the system work better than it will as written. The individual mandate could be delayed while the colossal technical bugs are worked out, tax credits and subsidies can be adjusted, health savings accounts can be given more support, and plenty more. But absolute stonewalling and repeal-or-bust is no longer an option.

There was value in ensuring the “Affordable” Care Act had no Republican votes when it was passed. The President and his party had to own it fully, and the GOP could keep their distance as it was implemented and provide a clear contrast for the next election. That worked well in 2010. Republicans swept back to power in the House and shrank the Democrat majority in the Senate. But that’s where the utility of the party-wide stonewall strategy ended. President Obama was reelected, his Senate majority increased, and the GOP lost a few House seats. Despite polls showing voters still skeptical of the law, all political capital to end it is gone.

We must accept reality and try to fix things instead of just getting in the way, if we don’t want to repeat 2012 in 2014 and 2016. The 2014 Senate map looks very favorable for Republicans. If they don’t screw anything up, they may take back the Senate with a slight majority. At that point they would have more political capital to push their own agenda with a unified Congress, but they must be careful how that is done.

While one party keeping the White House for more than 8 years is difficult, even if a Republican is elected President, the Senate map isn’t very favorable. The entire “Tea Party class” of 2010 will be up for reelection then, and as that brand’s viability wanes, the blue state members of it will be in trouble. Unless the Republican nominee has enough appeal to influence down-ballot elections, Democrats may win back a slim majority in the Senate.

The likely reality of the next two elections make full repeal of Obamacare next to impossible, no matter how badly it fairs over the next few years. However, we might be able to improve those electoral realities by being productive instead of obstructive, and trying to put the fire out instead of sitting back and watching it burn. Most voters aren’t the Joker.

 


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