The right doesn’t want Obamacare fixed. But it’s even worse for them if it fails.

October 21, 2013

The launch of the Affordable Care Act's federally run, online insurance portals has been a bit of a disaster. But it's not a disaster that actually does much for the GOP's case against Obamacare. The fact that the site buckled under overwhelming demand shows some flaws in the digital architecture, sure, but it also shows that there was overwhelming demand. The possible problems in the handshake between the government's computers and the insurance industry's systems are worrying, but they don't have much of an ideological valence.

What's a few words between friends? (AP Photo/Senate TV)
What's a few words between friends? (AP Photo/Senate TV)

The core problem for the GOP is that they're complaining about problems they don't actually want fixed. So the criticisms have an oddly self-negating quality: Republicans are furious that more people can't sign up for this law they want to repeal altogether.

Some Republicans have responded to this by wildly exaggerating the claims of Obamacare's critics. Since I've been harshly critical of the law's rollout, I've gained a lot of new fans among the law's opponents. But because my criticisms are oriented toward fixing a law these folks want to repeal, there's been a certain looseness in the way my arguments have been described. Here's Sen. Ted Cruz on Mark Levin's radio show:

There is so much widespread agreement that this thing is a train wreck. You've got Wolf Blitzer on CNN saying the president should delay this for a year. You've got Ezra Klein coming out in The Washington Post saying the president should delay it for a year.

I never said that. I think delaying the law for a year would be a disaster. But my view of what should be done -- which mostly amounts to: fix the Web site, and quick -- isn't worth much to Cruz. If the Web site was running smoothly, that would be much worse for him.

Similarly, the Daily Beast reported that:

Other Republicans were more optimistic that they could defund Obamacare. The chair of the Republican Study Committee, Steve Scalise (R-LA), thought it was still “entirely possible” even with a Democrat in the White House. This hope was shared by Rep John Fleming (R-LA) who said “the biggest threat to America today is not shutdowns, it’s Obamacare.” He said that it was clear that it would be a disaster and cited liberal pundit Ezra Klein of the Washington Post, who he claimed shared his views.

Again, not so much. But if you want to repeal Obamacare it doesn't do you much good to quote more modest critiques of the Web site. You see the same problem afflicting tech-savvy Republican strategist Patrick Ruffini:

ruffini aca

This is a more serious point, and it deserves to be taken seriously. But it's perfectly clear that government is more than capable of building a working insurance portal. The Massachusetts government did it years ago, and California, Washington, Kentucky and other states have already done it under Obamacare. Medicare Part D's Web site was three weeks late in launching. Its early months were a mess, but today both Republicans and Democrats agree the program is a success. Moreover, every other developed nation has some sort of government-run national health-care system, and those systems have broader coverage, lower cost, and comparable outcomes to our own.

All this drives toward a subtler and, for the right, more disturbing point. The part of Obamacare that's troubled is the part Democrats lifted from Republican policymakers. It's the part that tries to integrate private insurance companies with government systems in order to create a universal insurance system that's subsidized by the state but run by private companies. The part that's working well is Medicaid -- which is to say, the part that's working well is the part that expands an existing, government-run, single-payer system.

As the New York Times's Ross Douthat writes:

While conservatives think the Obamacare exchanges are overregulated and oversubsidized, they are actually closer to the right-of-center vision for health care reform than the Obamacare Medicaid expansion, which is happening no matter what transpires with Healthcare.gov. So if the exchanges fail and the Medicaid expansion takes effect (and, inevitably, becomes difficult to roll back), we’ll be left with an individual market that’s completely dysfunctional and a more socialized system over all.

Obamacare isn't "the left's" grand plan. Their grand plan is Medicare-for-all. Obamacare is a compromise between the left's vision of universal health care and the right's hatred of government-run insurance. It's based off a blueprint developed by the Heritage Foundation, introduced into the Senate as a Republican alternative to Bill Clinton's health-care ideas, and passed into law by then-Gov. Mitt Romney. It's true that Republicans abandoned their idea when Democrats decided to adopt it but that doesn't change the intellectual lineage -- or the point of the plan.

Put aside whether Obamacare's failure would hurt President Obama, who will never be on a ballot again, and look instead at what it will mean for health-care policy broadly. The case that can be made against the difficulties of implementing a system this complex isn't a case for the status quo. Nor is it a case for Republican health-care ideas, insofar as they exist. After all, Rep. Paul Ryan's health-care plan -- and his Medicare plan -- would also require the government to run online insurance marketplaces. It's a case for a much simpler, government-run health-care system.

Republicans don't want to see Obamacare fixed. But, long term, it's even worse for them if the part of it that tries to build on the private insurance system fails.

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Sarah Kliff · October 21, 2013