Watch out, Republicans! You’re helping Obamacare succeed.

July 25, 2013
OBAMACARE004_1332953760
(Bill O'Leary/The Washington Post)

Republican opposition to Obamacare is, Norm Ornstein writes this morning, "spinning out of control."

"What is going on now to sabotage Obamacare is not treasonous — just sharply beneath any reasonable standards of elected officials with the fiduciary responsibility of governing," he writes in National Journal, of Republicans' new threat to defund Obamacare or shut down the federal government.

"One might expect this kind of behavior from a few grenade-throwing firebrands. That the effort is spearheaded by the Republican leaders of the House and Senate...takes one's breath away."

Republicans have taken no shortage of pride in their success at blocking the Affordable Care Act. Even with President Obama in office and the Supreme Court upholding the law, the party has arguably succeeded in hampering the Affordable Care Act.

Twenty-one governors have opted out of the Medicaid expansion, even more refused to set up a health insurance marketplace. Obamacare will undoubtedly expand health insurance to fewer Americans as a direct byproduct of Republican resistance.

But there's something else Republicans have been doing that, in a weird way, will likely help the Affordable Care Act. Namely, they have predicted the law's complete and utter implosion when it launches on Oct. 1.

Senators say premiums will skyrocket; ads claim that Americans will lose access to their doctors. The health-care system we have right now, numerous legislators will warn, will quickly become a relic of the past. There's even a rumor floating around right now that Obamacare will require every American to get a microchip implanted in their hand or neck that will contain their health and bank records.

Republicans have set Obamacare expectations so incredibly low that, if Godzilla doesn't march in on Oct. 1 and gobble up our health insurance coverage and legions of IRS agents fail to microchip the masses, that could plausibly look like a success.

One worry I hear a lot when I talk to state bureaucrats and consultants – the people actually setting this law up on the ground – is a persistent worry that expectations are being set too high. They cringe when President Obama tells the American people that, come Oct. 1, they will be able to "comparison shop in an online marketplace, just like you would for TVs or plane tickets."

State officials think that buying health insurance will be easier than it is right now, but still complex. In the first few months, there will be bumps and glitches. It will take a whole lot longer than buying a television at Best Buy or a plane ticket on Expedia. Some people might get shuffled between different government agencies. Others might be told they're not eligible for a program they thought they should receive, and need to spend hours on the phone hashing out the details.

Buying health insurance under the Affordable Care Act requires entering in a Social Security number, an annual income and a detailed list of all family members. Buying a television or a plane ticket does not.

"A lot of what we do right now is manage expectations," Kevin Counihan, who runs Health Access CT, told me when I spent a few days shadowing him. "I was with the Connecticut Medical Society recently and a lot of what I was doing was calming the waters, telling them that it's not going to be perfect. It's going to be clunky."

Would Obamacare be an easier lift if Republicans were working hand-in-hand on implementation? Probably. Have Republican predictions of the health law's failure made it harder to set it up? From the view of supporters on the ground, at least, that doesn't seem to be true.

Republicans are, in a way, doing that job quite well as they issue predictions that the law simply cannot, will not work. When the bar is that low, succeeding becomes just a little bit easier.

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