Although Republicans have done a bang-up job of blurring the issue and diverting the public’s attention, Obamacare remains a problem for Democrats and a burden for their incumbents up for reelection in 2014.
If the Republicans could get away from the unpopular shutdown fight and focus fully on Obamacare, they might benefit from three factors that threaten the president’s signature legislation.
First, the problems with the exchanges are potentially serious and long-lasting. As the Wall Street Journal reports, “The website is troubled by coding problems and flaws in the architecture of the system, according to insurance-industry advisers, technical experts and people close to the development of the marketplace.” This is not, as the administration previously claimed, simply a capacity problem. (“Among the technical problems thwarting consumers, according to some of those people, is [getting] the system to confirm the identities of enrollees. Troubles in the system are causing crashes as users try to create accounts, the first step before they can apply for coverage.”)
Second, the “affordable” part of the Affordable Healthcare Act is missing and threatens to undermine incentives for uninsured Americans to sign up. A Bloomberg report confirms:
Over time, rather than encourage insurance providers to offer ever more attractive and affordable policies, the exchanges are poised to push up the cost not only of insurance but also of health care itself. That means, if the history of U.S. health-care policy is any guide, the exchanges’ very “success” will have the effect of limiting access to care for the 30 million people who are estimated to remain uninsured.
This is because rather than setting up a true market, Obamacare has set up the equivalent of regulated utilities in which there is restricted choice by design. That, plus the heavy subsidies, puts less, not more, pressure, on cost. Just as in the present employer-provided insurance system, the patient is not the one bearing the full cost of his choices. And then, the Bloomberg report points out, “[T]here’s plenty of evidence that insurance itself can drive up the cost of care — when both insurers and beneficiaries are undisciplined in controlling prices.” This is especially the case when Obamacare mandates 80 percent of insurance company revenue be spent on health care.
And, third, as a result of both the exchange defects and the cost increases, Obamacare may simply not work, meaning not enough people will sign up. The problem becomes more acute when the healthy young people, needed to subsidize costs of older and sicker Americans, refuse to play their assigned role. Right now, the system is in such disarray that the administration claims not to know how many people have actually enrolled — a fact advertised and mocked by Obamacare critics.
But soon it will be known. When it is, the magnitude of the Democrats’ problem will become clear. That, not a fixation on blaming the White House for the shutdown, should be front and center in Republicans’ message to voters.
Republicans arguably should have more faith in their own position. From the get-go they have claimed Obamacare is unworkable and won’t provide universal, affordable care. Now they get to show the American people they had it right all along. Maybe, then, they should work on documenting the problems and coming up with their own alternative. That would be both politically smart and responsible. If Obamacare is as bad as they say, shouldn’t they provide an alternative that will work, at a lower cost and with fewer adverse effects? That would go a long way toward showing Republicans can govern responsibly.