September 13, 2013

If you want to get a sense of the hardships the coming battle over Obamacare implementation could present for Republicans, check out this compelling local newscast out of Virginia that was flagged for me by a Democrat.

It reports that at least 200,000 Virginia residents could be in danger of falling into the “Medicaid gap,” i.e., they are too poor to qualify for the law’s subsidies, but also will not enjoy the benefits of the law because Virginia has opted out of the Medicaid expansion:

What you see here is another way in which we may be heading into new political territory in the battle over Obamacare, now that its benefits are set to kick in this fall. The media and political discussion is heavily focused on the problems implementation may bring. There’s no denying that there will likely be glitches. Those are likely to be hyped in the press — egged on by Obamacare foes — into proof that the law is a uniform disaster. But as more and more people have their own concrete experience of the law and its benefits, the Republican arguments about it could get harder to make.

In recent days some Republican governors have broken with the conservative demand that they must swear off the Medicaid expansion entirely. Governor Tom Corbett of Pennsylvania, who previously opted out of the expansion, is now set to roll out some sort of Medicaid expansion plan of his own that would expand coverage to poor Pennsylvanians. While it’s unclear what it will look like, it might require new recipients to purchase private insurance with the help of federal expansion money, which looks like an expansion of the safety net.

Meanwhile, Ohio governor John Kasich, who has announced the state will opt in to the expansion but is running into resistance, is now aggressively battling GOP lawmakers in his own state who oppose opting in, arguing that it’s folly for the state to reject federal money that can be used to treat their own constituents.

The bottom line is that as the law kicks in, for many people, this will no longer be an abstract political debate that can be easily manipulated by lies and distortions. The debate over the Obamacare long depicted as a Kenyan Muslim Marxist plot to destroy American freedom will now be vying with the debate over the various ways the law expands coverage to real people while protecting living, breathing consumers and people with preexisting conditions.

Whatever the political difficulties Dems face — and there will be difficulties, to be sure — Republicans will also face formidable political challenges as Obamacare rolls out. Republican officials who are trying to sabotage the law will no longer be able to scream about death panels and jackbooted IRS thugs looking to turn ordinary Americans into Obamacare slaves. They’ll now be in the position of standing in the way of increased access to health coverage for their own constituents.

Greg Sargent writes The Plum Line blog, a reported opinion blog with a liberal slant -- what you might call “opinionated reporting” from the left.