With her appearance on Capitol Hill on Wednesday, Health and Human Services Secretary Kathleen Sebelius' role as the focus of Republican attacks on Obamacare hits its possible pinnacle. The Republican campaign against Obamacare, piling on every new piece of the law as it comes on line, will continue on after Sebelius moves to the background. Loaded with money, energy, and targets, the Republican Party finally has in Obamacare a campaign against President Obama that it can win — for certain definitions of win.
The party's fury at the president and his signature policy effort is longstanding. The 2008 and 2012 campaigns were explicit contests between Republicans and Obama. And the Obamacare fight has been an attempt to damage the president. In July, we suggested that the Obamacare push was Obama's third, most important campaign. Little did we realize just how accurate that would be.
For months, before the insurance exchange part of the law was even close to implementation, the effort to damage Obamacare centered on slicing its funding. Those 40-plus votes to defund or rollback Obamacare now seem almost quaint, representative of a simpler time when attempts to undercut the policy were still mostly theoretical.
On October 1, that changed. For the first time, Obamacare was tangible, in the form of Healthcare.gov. Simultaneously, the Republicans laid all of their pre-launch cards on the table, pushing for a last-gasp execution of the policy under threat of a government shutdown. That fight, the GOP lost. The website fight, thanks to Sebelius' mismanagement of the process, it's having more luck with. Remember right after the shutdown, when the party shifted its strategy to attack the website instead of the law on the whole? There was never any strategic shift, just (as Bloomberg noted) a tactical one. The strategy was the same: Toss every sink from every kitchen until the end of time.
Sebelius isn't the only one ducking from flying faucets. The Republicans' current targets are: Sebelius, Healthcare.gov, state roll-outs, Obama's claim that people could keep their plans, and funding. In other words: every manifested aspect of the Affordable Care Act.
As National Journal points out, Sebelius' job is probably secure. Obama learned early in his tenure that firing embattled staffers didn't bear much fruit (see: Jones, Van). The administration's strategy seems to be to hold its breath, hoping that Healthcare.gov suddenly refreshes itself into competence. (Sebelius' strategy: blame the contractors.)
The "you can keep your own plan" attack is stronger, in the moment, largely because it is necessarily a fight over anecdotes. (See our past pieces on the topic.) Obama was granted four Pinnochios from The Washington Post for his repeated insistence that people could keep their health care plans — though the paper's editorial board points out that the reason the claim was false is primarily that many people had sub-par healthcare plans. Stories like this one, from a guy angry that he'll pay more for an Obamacare-compliant plan, will be picked up in the media, while, as Brian Beutler notes at Salon, those who see benefits will likely not write exciting, angry blog posts about their quiet contentment (though the media will pick up noteworthy stories, like this one from Pittsburgh). But an anecdote battle a tough fight to win over the short term.
This fight is the campaign against Obama that the Republican party wishes it could have run last year. And it's a campaign which, to some extent, it can win. On Tuesday, the party launched a series of ads (one of which is at right), echoing the rather stale Apple-versus-PC debate of a few years back. It's framed as a fight between a straw-man Obamacare and a straw-man "private sector." Raise your hand if you're ever had complaints with private companies resolved as quickly and pleasantly as the gentleman in the video.
But the point is clear: Beyond including the president's name as part of references to the policy itself, this is the RNC against Obamacare. To their benefit, there's no Election Day and no well-financed opposition. Super PACs are weighing in. Obama and his allies are trying to highlight the benefits of the law — expanded coverage, coverage despite pre-existing conditions, insurance rebates, and so on — but that's like giving a stump speech in a city in Ohio. Same message, small audience.
What does victory in this campaign look like? It looks like a policy that's hobbled, in actuality or in interpretation. It looks like an Obama administration that spends the next three years fighting to defend the policy gains of its first year, instead of pushing other initiatives. It looks like a former president Obama who's remembered as a failure, not a success. There's no Election Day, but there is an historic judgement. For Republicans, shaping that is victory enough.