May 10, 2013

This afternoon, President Obama will hold an event at the White House where he will discuss the benefits his health care law, the Affordable Care Act, has for women. In particular, he will ask mothers to encourage their children to take advantage of the law and sign up for coverage through the health exchanges. This is key; the exchanges only work to control costs if a large number of healthy young people sign up. Otherwise, they become a dumping ground for sick and older Americans, who have much higher health costs.

This is part of the White House’s general push for implementation, which has emerged as a key political issue. Republicans are convinced the law will be a disaster, and Democrats are worried they’re right. Of course, as Greg pointed out the other day, for Democrats, nervousness is a good thing — it helps them stay careful and cautious as they move forward with the law, which can help them avoid implementation mistakes. Republicans, on the other hand, see the potential hazards of implementation as another reason to repeal the law. Earlier this week, in fact, House Republicans announced another bill to repeal Obamacare, and Senate Republicans have opted to ignore a provision that requires them to pick someone for the Medicare cost review board.

Attempts to repeal the Affordable Care Act didn’t pay off politically last year, but it’s not hard to understand why Republicans continue with the effort. Even if implementation is full of problems — and it will have its challenges — it’s still true that when all the parts go online, millions of Americans will receive health insurance when they didn’t have it, and millions more will be able to afford new, more comprehensive insurance. Real people will receive real benefits, which they won’t want to give up. Eventually, if things progress on the current path, Republicans will be left in a position where they long opposed an entitlement their own voters have come to rely on. At this point, their only hope is to stop the law from going into effect.

It should be said that Republicans had a chance to prevent this outcome. During the fight for health care reform, Democrats were desperate for bipartisan cover. It’s not a stretch to think that Republicans could have dramatically watered-down the health care law if just a few agreed to support it. Instead, by opposing it completely, they kept it a purely Democratic bill, and thus a much more liberal law than it might have been. And so, if the GOP finds itself stuck with a comprehensive overhaul of the health care system — one that they can claim zero credit for — they only have themselves to blame.

Jamelle Bouie is a staff writer at The American Prospect, where he writes a blog.