Democrats are affronted that Republicans have made Obamacare a focus of this fall’s fiscal fights.
They should get used to it. Even if Democrats deflect efforts to defund or delay the law in coming weeks, the fight will go on. Republican opposition is for the long haul, and it should be.
Even as the exchanges for individuals to purchase insurance get up and running, Obamacare is still in play. It has a legitimacy problem. It had one before it passed, when it was kept afloat through gross special deals, and it has one still, when it is manifestly failing to live up to the president’s salesmanship on its behalf. There’s a reason that usually we don’t pass major social changes lacking popular support on party-line votes — it is a formula for conflict rather than consensus.
Having done the deed, Democrats now expect Republicans to salute smartly, accept “the law of the land” and suggest minor improvements that Democrats will, in their wisdom, decide whether or not to adopt. In other words, they recommend the acquiescence of surrender. If this were a consistent principle rather than opportunistic advice, Democrats would have been content to leave “don’t ask, don’t tell” in place and never would have agitated to repeal the Bush tax cuts, out of deference to duly constituted policy and law.
Nearly four years after Obamacare passed, the coalition against it has expanded rather than shrunk. The unions are now excoriating the law in terms that once would have been reserved for Republican floor speeches. During his filibuster, Texas Sen. Ted Cruz repeatedly quoted a letter from Teamsters leader Jim Hoffa attacking Obamacare as a clear and present threat to the middle class. When House Republicans voted to delay the individual mandate a few weeks ago, 35 Democrats joined them; Joe Manchin, the Democratic senator from West Virginia, announced his support for a delay just last week.
Pew Research has found disapproval of the health-care law at an all-time high in its polling. CNN’s latest survey has disapproval at 57 percent and approval at 38. Health care, a core Democratic strength for decades, is becoming a liability. A New York Times poll found that more people disapprove of President Barack Obama on health care than approve by a 54 to 40 margin. Trust for Republicans and Democrats on health care is about even, according to the Pew poll.
The problems with the health law are invariably described by the president and his allies as “glitches,” or harmless technical snafus that no one should worry about. But the law suffers from basic design flaws beyond the question of whether the Obama administration can get its software to work. It depends on young, healthy people buying insurance even as it reduces their incentive to do so; it encourages employers to dump workers off their current insurance; it suppresses full-time work, through the employer mandate; in 10 years, the law still leaves 30 million people uninsured.
None of this makes for a stable, widely accepted new dispensation in American health care. On the right, ironically enough, it is Cruz and his band of fellow defunders who are the defeatists on the law’s medium-term prospects. They argue that unless it is stopped before Jan. 1, when subsidies begin to flow through the exchanges, it will be an unalterable part of the American landscape. But at first only about 2 percent of people will receive subsidies, which are funneled through insurers rather than given to individuals directly. The subsidies themselves shouldn’t be enough to save Obamacare if it is failing.
The law’s fate over the longer term matters because it is almost certain to survive the immediate confrontations over the so-called continued resolution and the debt ceiling. It will be determined over the course of the next two elections, when Republicans will continue to pound away — rightly — over the sighs of annoyed impatience of the left and the media. Resistance is not futile.
Rich Lowry can be reached via e-mail at email@example.com.