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Why Does It Matter How Many People Signed up for Obamacare?

by Michael Austin, published

Last week was all about the spin. According to the Obama administration, 7 million people signed up for insurance through the exchanges created by the Affordable Care Act. Republicans were quick to dispute the claim. Charles Krauthammer immediately called it a “phony number,” and Bill O’Reilly said that the White House was “straight up lying” about the number of people enrolled.

Nonetheless, Obama seems to have won the short game. He has enjoyed a small-but-real uptick in the polls, and a general consensus that the ACA has brought the number of uninsured Americans down to its lowest level in years. And, of course, the House of Representatives failed to repeal Obamacare in its 50th attempt — a dismal record for anyone who is not a Cubs fan.

If the Obamacare bounce holds up—and there is certainly no guarantee that it will—Republicans could end up losing more than a few symbolic votes. The 2014 midterm elections are already shaping up to be a referendum on the dismally unpopular health care law. If the ACA becomes only moderately unpopular, it could cost Republicans control of the Senate, which, as it stands now, will change hands only if the GOP wins every seriously contested seat in the country.

And this is why everybody seems to be focusing on the seven million figure, even though the number of people who signed up for Obamacare should not actually matter to the debate.

When the Affordable Care Act was passed, there was an actual debate that, when stripped of hyperbole, came down to two rational positions that reasonable people could disagree about: 1) that new insurance programs could accomplish a societal good by increasing the number of people with health care coverage; and 2) that universal health insurance went beyond the legitimate powers of government and would create an entitlement that we could not afford.

However, when the ACA launch was plagued with technical failures, delays, and unwise executive exemptions, the Republican position shifted from, “this is an unwarranted expansion of government that we cannot afford” to “this is an unmitigated disaster that won’t ever help anybody do anything.” And it worked. The president’s popularity sank to new lows, and the Republicans started to contemplate control of the Senate. In the process, though, they freely conceded to the Affordable Care Act the most important rhetorical advantage possible in the world today: low expectations.

And this is why the seven-million figure is so important. A lot of people signing up for insurance does not mean that the ACA is a good thing, or that we can afford it, or that it is a legitimate use of government power. All it means is that Obamacare is not a complete disaster. One can still disagree with it, and give very good reasons for doing so. But if it is actually helping a large number of people get insurance, then one’s disagreement must acknowledge things like trade-offs, partial goods, lesser evils. And one might even have to compromise.

This is how self-government is supposed to work, of course. It is how American politics has inched forward for more than 200 years. But it is a bad fit for the contemporary political world, where absolute evil is the only legitimate enemy and where lost causes are the only ones worth fighting against.

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