In five days, millions of people who aren't currently insured will suddenly have health care coverage under Obamacare. This puts Republican opponents of the program in a difficult position. If you've been railing against people getting kicked off of their plans, what do you do next? The best political answer may be simple. Nothing different.
The New York Times reports that Republicans aren't entirely sure what to do at this point, but are facing pressure to do something. After months of campaigning against the Affordable Care Act and in the wake of the law's fumbled implementation, Republican voters expect action — "nearly two-thirds of Republicans wanted to have the Affordable Care Act repealed," the paper reports, "and most Republican lawmakers are appealing to those constituents." There are some Republican proposals in the works that would change the policy: Georgia Rep. Tom Price proposes scrapping the law, but keeping the pre-existing condition requirement; Wisconsin's Paul Ryan is coming out with a plan soon. Neither would be signed into law, and, The Times notes, Republican approval on health care is even lower than President Obama's.
Leading to the fundamental question, as articulated by South Carolina Sen. Lindsey Graham:
"The hardest problem for us is what to do next,” Mr. Graham said. “Should we just get out of the way and point out horror stories? … 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."
"It’s no longer just a piece of paper that you can repeal and it goes away," Wisconsin Sen. Ron Johnson told the paper, given that people now have coverage. Earlier this month, Salon's Brian Beutler, with some prescience, anticipated this bind. According to estimates in the wake of the December 24 deadline, at least 2 million people will have enrolled in the federal and state exchanges. And as The Washington Post reports, nearly 4 million people have gotten coverage under the expansion of Medicaid and the State Children's Health Insurance Program. That's six million new enrollments, at least: 1.8 million higher than even Fox News' estimate of those who've seen policies cancelled. In Johnson's words, "There’s something there."
That reality hasn't sunk in for the public. Opposition to Obamacare is still politically potent, as evidenced by a new push from the conservative PAC Americans For Prosperity. As Politico reports, the group just launched ads targeting two freshman House Democrats, trying to link them to Obama's "if you like it, you can keep it" flub. It's an odd strategy — neither representative was in Congress when the ACA was voted on, and the Republicans already have a strong majority in the House. But AFP is investing $600,000 early in the campaign cycle, likely suggesting that polling shows something not easily seen with the naked eye.
The main reason the electoral push against Obamacare will continue is because of demographics. The large majority of those who've gotten coverage are low income Americans covered under Medicaid. And as the graph at right (from Nonprofit Vote) shows, low income Americans are much less likely to vote. What's more, in the 2014 off-year election Republicans will almost certainly comprise a higher percentage of the electorate than they did last year. Two-thirds of whom, at this point, want Obamacare gone — in part, because most of them aren't recipients of new policies.
So why not keep pushing for reform in the abstract? Obamacare may already have simply become another government program that, like the "entitlements" of Medicare and Social Security, exists in the disparaged background of national politics, something that people want to cut in the abstract and (at least eventually, for Obamacare) keep intact in practice. Given the demographics and the timeframe, it will probably still be a punching bag next November, and will still prompt furious floor speeches on behalf of doomed legislation. In 2015, though, that furor will likely be gone.