Top Republicans privately recognize that repeatedly trying to repeal the Affordable Care Act is no longer a winning strategy. For Democrats, there is the risk that new problems will emerge within a program that still lacks strong leadership. They may also find that history doesn’t suggests the health care law will redound to their political advantage as more benefits kick in.
Republicans may face the biggest shift in public opinion. Some party strategists note that healthcare.gov seems to have largely recovered from its dismal debut and that about 10 million Americans who didn’t have insurance will soon have it — including those who have signed up on the federal or state exchanges or enrolled in Medicaid, as well as young adults who have been able to stay on their parents’ plans longer. Other benefits will also prove popular as the changes take effect.
A Republican leader said the public invariably resists measures that affect the stability of their health care; that was a big factor in Obamacare’s unpopularity. But as this year progresses, even with its unpopular parts, the new policy will normalize and its possible repeal will become destabilizing.
In 2014, a premium will be placed on Republican proposals to offer alternatives. But the right-wing base has minimal interest in alternatives to the law and loves the political red meat of repealing it. Also, most of the Republican proposals offered so far would result in less coverage and provide little cost containment; moreover, there has been a significant slowing in the growth of health care costs in recent years.
Democrats worry about more people losing their current coverage, a political liability that’s proving more troublesome than the website glitches. They’re also concerned that new bureaucratic hurdles will surface and that the law’s higher fees and taxes will put them on the defensive before the 2014 elections.
The calculation, by more than a few Democrats, that voters will reward them politically as the program becomes more popular is belied by previous experiences with major health-care policies.
Medicare was enacted in 1965, and proved enormously popular, yet Democrats suffered losses in the next several elections. The Medicare prescription-drug benefit was enacted during George W. Bush’s administration and the president’s advisers thought it would be a big advantage for him in his re-election campaign. It wasn’t. And Romneycare, the Obama-like health-care proposal enacted in Massachusetts when Mitt Romney was governor, has lots of fans in the Bay State, but it hasn’t provided any political benefit for Republicans.
Albert R. Hunt is a columnist for Bloomberg View.