More Bad News For Republicans About Obamacare

(Cartoon about Republican lies on Obamacare is by Nick Anderson in the Houston Chronicle.)

The Affordable Care Act didn't get off to a great start. Computer glitches kept many from signing up the first month, and some people with inadequate policies found those policies had been cancelled because they did not cover everything the law said they must cover. The Republicans loved that. They thought some of the lies they had been telling about the Affordable Care Act (Obamacare) might actually be coming true, and they chortled with glee.

But those early problems were fixed, and it didn't take long for the Republican celebration to turn into a miserable defeat. Obamacare eliminated pre-existing conditions, removed caps on what insurance would pay for medical care, allowed young people to stay on their parent's insurance -- and perhaps best of all, allowed millions of people to get insurance that couldn't afford it before. In the first year, over 8 million people singed up for insurance (more than a million more than was predicted), and in the second year that jumped up to about 12 million (again, more than predicted).

That would have been bad enough, but the good news about Obamacare just kept pouring in. Many people got a premium refund in the first year (because the insurance companies weren't paying out enough of those premiums for medical care), and the rise in premium costs for consumers has been less than expected. Hospital costs have also risen far less than in the past (because more people have insurance and they don't have to raise costs on everyone else to pay for those who don't).

Those things alone would be enough to declare Obamacare a success, but there's more. Last Monday, the bipartisan Congressional Budget Office significantly lowered its estimates of what Obamacare is going to cost. Last January they estimated Obamacare would pay out $1,058 billion in subsidy costs over the next decade, but now they say that cost will only be about$849 billion (a drop of $209 billion, or about 20%). They also predicted that Medicaid would cost $920 billion over the next decade, but now say it will only cost $847 billion (a drop of $73 billion, or about 8%).

It seems like the good news for consumers and taxpayers just keeps coming -- and the bad news for Republicans won't stop. And among that bad news is their utter failure to come up with a viable alternate plan of their own. A few plans have been touted, but all of them would be more expensive for consumers, cover less than Obamacare, and provide insurance for millions less people than Obamacare -- and none of those plans has been able to garner anywhere near majority support from Republicans.

After five years of whining about Obamacare and promising to come up with a better plan of their own, the Republicans still don't have an alternate plan to fix our medical care system -- and it looks very unlikely they'll be able to come up with a plan in the future.

Jonathan Chait has written an excellent article for nymag.com on why the Republicans haven't, and probably can't, come up with an alternate plan. I urge you to read the whole article, and to whet your appetite, I give you this part of that article:

The Republicans have had six years to develop an alternative to Obamacare. Before that, they had three previous presidential administrations (Reagan and both Bushes) since the conservative movement rose to power with which to develop a response to the decades-long American health-care crisis. They are no closer today than they were when the health-care debate began in Congress.

And the reason for the absence of a specific, partywide alternative is that Republicans don’t just have different goals than Democrats, they have different kinds of goals. 

Obamacare was designed to reduce the physical, mental, and financial stress that comes with lacking access to health insurance, while also slowing down the long-term growth of medical costs. Those are specific, measurable goals. Republicans have insisted the law would fail to meet its objectives — costs would run higher than expected, workers would be forced into part-time jobs, the law would even fail to reduce the number of uninsured. None of those things have happened.

All the Republican predictions have failed. Just this week, the Congressional Budget Office once again revised down its cost projections for the law, which is now projected to cost 20 percent less than originally estimated. Given conservative certainty that the opposite would occur, you might expect some revision. But conservatives have not abandoned or even reduced their fervent opposition to Obamacare. This is because the right’s specific, measurable predictions about the law are subordinate to deeper, philosophical beliefs. They oppose the law’s methods (more taxes, spending, and regulation) on principle. They believe those methods will fail to achieve their stated goals, but even if they succeed, they oppose them anyway. Republicans cannot design a partywide health-care alternative because they cannot reconcile the specific things most Americans want from the health-care system (access to affordable insurance, protection from discrimination against preexisting conditions) with their ideological commitments. . .

For Republicans to actually unify around a health-care plan would require them to oppose every tendency that defines their party. They would have to side with the specific programmatic desires favored by the voters rather than its abstract ideological goals. They would need to compromise with the opposing party rather than stick to principle. Republicans won’t have a real health-care plan until they become a different kind of party.