The Obamacare Effect

Be sure to see “Saved by Obamacare,” by fiction writer Elizabeth Hand. The article is not fiction; it’s about her experience with the ACA and why she’s grateful for it.

The wonder is, why isn’t the Administration, or some progressive group like MoveOn making ads with such stories to run in mass media? I honesty don’t understand. Maybe somebody is doing this, but I haven’t seen it. Or maybe powder is being saved until we’re closer to the midterm election. But they don’t want to wait too long, I don’t think.

At this point it’s obvious to all but the most demented that the ACA is working about as well as originally hoped. Which is to say it’s not perfect, but it’s not bad.

Speaking of which, as conservatives are trying to suss out White House manipulation of the Census Bureau, Obamacare keeps on doing exactly what it was intended to do. This week the Congressional Budget Office found that Obamacare will cover more people for less money than initially estimated, and that insurance premiums likely will not spike next year, thus driving a stake through three core conservative attacks on the health law.

Health insurers, who just last month were floating anonymous warnings of massive premium increases, are now starting to warm to the state health exchanges. “At least two major national insurers intend to expand their offerings,” reported Politico on April 16, “although a handful of big players like Aetna, Humana and Cigna, are keeping their cards close for now. None of the big-name insurers have signaled plans to shrink their presence or bail altogether after the first rocky year. And a slew of smaller health plans are already making moves to join more states or get into the Obamacare business for the first time.”

Ezra Klein writes that Republicans suffer from Obamacare Derangement Syndrome.

Today, the right struggles with Obamacare Derangement Syndrome: the acute inability to see Obamacare as anything but a catastrophic failure that the American people will soon reject. For those suffering from ODS, all bad Obamacare news is good news, and all good Obamacare news is spin. In this world, delays of minor provisions in the law prove that the entire structure is collapsing, while surges of millions of people enrolling in insurance don’t prove anything at all.

ODS has kept Republicans from updating their mental model of how Obamacare is doing. To them, the law’s disastrous rollout proved that it was doomed. The fact that it recovered beyond anyone’s expectations — literally, not a single analyst or policymaker I spoke to in December thought it credible that the exchanges would sign up 7 million by April, much less 7.5 million — hasn’t made much of an impression.

Most of them aren’t changing their rhetoric in light of changing realities. This is mostly because they’ve put themselves in a box with the base. They’ve been telling the base that no terms but unconditional surrender will be accepted — repeal, in other words — and the base will interpret any GOP waffling or compromise as failure.

There are still many good critiques to make of Obamacare. But Republicans don’t want to critique Obamacare. They want to stop it. Repeal it. They want to make it the hill big-government liberalism dies upon. And those in the party who know better continue to be cowed by those in the party who don’t. So long as Ted Cruz is going to New Hampshire promising that Obamacare can be stopped, no Republican can step before the faithful and outline a plan for how it can be tweaked.

And they can’t come up with an alternative plan, because the ACA WAS their alternative plan.

The other problem for the White House is that many think Obamacare is basically working despite the Obama administration’s best efforts. The roll-out really was a disaster, the law remains unpopular, and estimations of the Obama administration’s competence are still low. The public would gladly flock to a political party that had a real plan for improving Obamacare, and a serious claim to being able to manage it more professionally. Luckily for the Obama administration, ODS ensures Republicans are still far, far away from being that party.

Someday historians may look back at 2013-2014 and conclude the terrible ACA website rollout worked in Democrats’ favor. It persuaded Republicans that a no compromises opposition to Obamacare would be a winning issue for them in 2014, and now they are so utterly committed to that I don’t think they can change. But neither do I think it will work for them all that well.