Obamacare Opponents Must Offer More Than Grand Gestures in 2014

With a new year bright on the horizon, the GOP plans to revisit an old foe: Obamacare.

Rather than cook up new strategies for the new year, though, New York University professor Sherry Glied expects the GOP will serve more of the same talking points.

“They can keep their base agitated and undermine any positive political spin the [Democrats] get from the law,” she said. “For now, there isn’t much chance they can repeal it, but that could change after an election.”

Stephen J. Farnsworth, political science professor at the University of Mary Washington, went even further.

“There’s no chance Obama will consent to any significant changes to the law,” he said. “Even if the GOP ends up winning everything in 2016, it’s going to be extremely hard politically to take away health care through a total repeal of [the Affordable Care Act].”

While Americans still have mixed feelings about the Affordable Care Act (22 percent considering it President Obama’s greatest achievement and 36 percent considering it his greatest failure, according to Gallup), the White House proudly announced more than 2 million Obamacare signups at the end of 2013. It’s worth noting, however, that some of the people included in that figure already had health insurance.

But if Republicans are going to even have a chance of challenging Obamacare in later years, they may need to come up with a functional alternative.

“I don’t think a return to the old status quo is really an option since there are already millions of people who have coverage under the law,” said American Political Science Association Congressional Fellow Jake Haselswerdt. “Republicans will have to come up with some sort of alternative that deals with that fact. They don’t want to run on taking people’s coverage away.”

Some are still focused on possible negatives of the Affordable Care Act rather than developing an alternative, however.

“This year, more and more individuals and employers will realize they are negatively impacted by Obamacare,” said Dan Holler, communications director for Heritage Action for America, a conservative policy advocacy group. “Importantly, the employer mandate — unilaterally delayed by the administration last year — will begin forcing employers to reduce hours, cut workers, and push employees into the Obamacare exchange.”

Even if the GOP ends up winning everything in 2016, it's going to be extremely hard politically to take away health care through a total repeal.
Stephen J. Farnsworth
Holler also said that problems with Obamacare cannot be fixed, and suggested that any related political action should be taken with the intent to fully repeal the law in 2017.

For now, though, opposition to the law may be primarily symbolic, according to Chad Murphy, assistant professor of political science at the University of Mary Washington.

“Many [Republicans], especially the newer members, were elected to repeal Obamacare,” he said. “So they need to show their constituents that they are at least putting in an effort. Senator Cruz’s shutdown was the last stand on this one though, and at this point it’s unlikely that we’ll see any changes in the law.”

But if Republicans are playing a waiting game, time may not be in their favor.

“It’s possible that by the general election campaign in the fall, the [Affordable Care Act] will appear more successful as memories of the website debacle fade,” said David A. Jones, political science professor at James Madison University. “Democrats are counting on that.”

As American health care continues to evolve, Haselswerdt expects the important fight to take place at the state level.

“The politics of Obamacare at the national level are little more than posturing, but the state-level struggles over Medicaid expansion have real stakes,” he said.

“The Supreme Court decision created a situation under which states could opt out of this, and a number of them have, which has prevented the expansion of coverage to millions of people. There will be continued conflict over this at the state level as health care providers and advocates for the poor clash with conservatives over whether or not to accept the federal money.”

The decision he referenced took place in 2012, when the Supreme Court of the United States ruled that states have the right to opt out of the Affordable Care Act’s Medicaid expansion. It was expected that the expansion would cover 17 million Americans by 2019. So, Haselswerdt’s estimate that millions of people could lose coverage thanks to state opt-outs is not an overstatement.

As of November 2013, 24 states have chosen to opt out.

Despite such opposition to the law, however, Republicans are facing an uphill battle.

“Fighting health care will be much harder in 2014 than it was before the law was in place and before the website was operational,” Farnsworth pointed out. “People without insurance are getting coverage this month, and they number in the millions. They will not be interested in hearing all this repeal talk.”