March 22, 2013

Yes, the 39th (!) Republican-instigated vote to repeal the Affordable Care Act is, as Steve Benen correctly says, an indication that the Republican Party has “a radicalized base that expects near-constant pandering.”

But if it’s not at an end yet, the end is finally near. Ezra Klein looks at the latest polling numbers from Kaiser and focuses on how little anyone knows about Obamacare — and that in fact, people seem to know less about it as time goes on.

I agree with Klein’s bottom line: Obamacare can have a hard implementation in 2014, but President Obama isn’t going to repeal it or even lose reelection over it (though congressional Democrats might). And by 2015, it will be insuring tens of millions of people, the health-care industry will have adapted and many businesses and ordinary Americans will be using the exchanges. At that point, no one is going to repeal it.

What I’d add is that “Obamacare” as such will probably stay as popular, or unpopular, as ever; Kaiser has consistently shown it fairly even, usually slightly below the break-even point. I suspect that won’t change.

However, once the exchanges and subsidies are up and running, and once Medicaid expansion happens, there will be millions of people who would have immediate, extremely tangible losses if it was repealed. Not only will that make repeal much less likely, but it will likely make even this silly string of repeal votes less appealing for Republican Members of Congress. Given that Republicans still, three years after ACA passage, never have figured out what they would replace it with, there’s just no way they would energize millions of people by taking away their health insurance.

The real fights now are, as Klein says, over implementation — and Ed Kilgore has an excellent, and not very cheerful, item about that today.

But the fights of the future will be closer to the realm of normal politics. Republicans may try to repeal Obamacare taxes, and everyone should certainly expect future fights over subsidy levels, specific regulations, and all sorts of other details. But “Obamacare” as an electoral issue is going to fade.

So enjoy these votes while they last, but realize they’re just a sideshow. If you care about health care reform, it’s not about Republican repeal votes or even public opinion; it’s all about how it gets implemented.