The politics of Obamacare are changing, and the Republican Party is well aware of that reality. “It’s no longer just a piece of paper that you can repeal and it goes away,” Wisconsin Sen. Ron Johnson, a Tea Party Republican, told The New York Times. “There’s something there. We have to recognize that reality. We have to deal with the people that are currently covered under Obamacare.”
Before October 1 — when the cornerstone provision of the Affordable Care Act, the online insurance marketplaces, had yet to launch — Republican lawmakers spoke of their desire to wipe health care reform off the legislative map by either repealing it in parts or as a whole, or by defunding it. The key, of course, was to accomplish repealing or defunding the law before the insurance exchanges opened for enrollment.
Even though other provisions of the Affordable Care Act had already been implemented, the marketplaces would not only be exceedingly difficult to shut down after they had been rolled out but the individual insurance mandate is also the most important piece of the reform. Texas Sen. Ted Cruz, also a Tea Party Republican, described the concerns and aspirations clearly and dramatically.
During an interview with conservative radio host Rush Limbaugh in late August, Cruz explained what he saw as President Barack Obama’s strategy for ensuring that the Affordable Care Act would not be repealed, significantly amended, or defunded. “He wants to get as many Americans as possible addicted to the subsidies, addicted to the sugar, because he knows that in modern times, no major entitlement has ever been implemented and then unwound,” Cruz said.
In other words, once the exchanges are open, it will be too late to prevent the overhaul of the American health system. And it is true that since Franklin D. Roosevelt signed the Social Security Act during the Great Depression, no benefit programs have been retracted.
The exchanges have been operating for nearly three months — one half of the enrollment period for 2014 — and while enrollments have not been nearly as strong as the Obama administration forecast and the January 1 start of Obamacare insurance policies is not likely to be without a glitch, Republicans are modifying their stance toward the health care reform.
Given that around 2 million people will have coverage from insurance purchased through one of the Obamacare exchanges and nearly 4 million people will be newly covered thanks to the law’s expansion of Medicaid, a change in party politics is an absolute must.
By the end of March, as many as 8 million to 10 million people may have insurance coverage thanks to Obamacare, so any Republican suggestions of repealing or replacing the health care reform would be a threat to those newly covered voters. “We have to recognize that reality,” Johnson told the Times. “We have to deal with the people that are currently covered under Obamacare.”
A strange twist of fate placed the beginning of enrollment for the Affordable Care Act and the first day of the new fiscal year on the same day: October 1. That coincidence gave Republicans an opportunity — or what they thought was an opportunity — to change the course of Obamacare history. But once the temporary budget deal was passed 16 days into the partial shutdown, which came from both parties’ inability to compromise, the GOP took most of the blame.
Even though Sen. John McCain called the effort to defund Obamacare a “fool’s errand,” most Republicans decided to move on, rather than focus on the failure. Now those that wish to reform Obamacare are a growing minority, evidence that the party’s Obamacare politics have changed from criticize and repeal to criticize and reform.
But more important to the changing politics of Obamacare is talk of offering a Republican alternative to health care reform before the 2014 midterm elections. Johnson told the Times that Congress should eliminate the individual mandate that requires all people — except those that qualify for a hardship exemption — to be insured but retain the individual insurance exchanges.
He also said the insurance options in those marketplaces should be expanded to include policies that do not meet the law’s coverage standards, including catastrophic plans. The problem is that most health care policy experts do not believe that solution is viable, The New York Times reports. Without the individual mandate and the tax penalty that enforces it, healthier Americans who are cheaper to insure, needed to keep insurers’ risk pools balanced, are less likely to purchase Obamacare insurance policies will not be compelled to participate.
According to Republican Sen. Lindsey Graham of South Carolina, what to do about health care has been the most-discussed topic debated in recent closed-door political sessions.
“The hardest problem for us is what to do next,” Graham said to the Times. “Should we just get out of the way and point out horror stories? Should we come up with a mini Contract With America on health care, or just say generally if you give us the Congress, the House and the Senate in 2014, here’s what we will do for you on multiple issues including health care? You become a more effective critic when you say, ‘Here’s what I’m for,’ and we’re not there yet. So there’s our struggle.”
More from Wall St. Cheat Sheet:
- Obamcare Enrollments: Federal Exchanges Soar as States Flounder
- Lobbyists Fight for Funding as Congress Sees Productivity Dips
- Obamacare: Will Last Minute Enrollments Help the ACA?
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