Even after it becomes law, major legislation is always subject to tweaks, additions and reforms. For something as large and sprawling as the Affordable Care Act, changes should be a matter of course. After all, this law promises to transform U.S. health care as provisions are implemented and benefits begin to trickle to ordinary people.
But as the New York Times reports, partisan opposition to Obamacare has thrown a large wrench into the normal process of legislative revision. Both Republicans and Democrats agree that “technical revisions” to the Affordable Care Act will be necessary as the law comes online, but large numbers of Republicans — desperate to see the law repealed outright — are unwilling to take those steps:
Republicans simply want to see the entire law go away and will not take part in adjusting it. Democrats are petrified of reopening a politically charged law that threatens to derail careers as the Republicans once again seize on it before an election year.
As a result, a landmark law that almost everyone agrees has flaws is likely to take effect unchanged.
It’s hard to overstate the extent to which this is a break with the past. The Social Security Act was followed by two decades of major changes, including a provision to extend benefits to dependents and another to bring domestic workers and farm laborers into the system, predominantly African American groups who were excluded on behest of Southern lawmakers. Likewise, as the Times notes, the Medicare Act came in for changes in 1967 and 1972, as lawmakers made corrections and adjusted for unforeseen circumstances.
Without the political leeway necessary to make adjustments to the Affordable Care Act, the ride to implementation may be bumpier than expected. This, in all likelihood, is the point behind GOP opposition to changing the law. Among conservative Republicans, there is still hope that Obamacare will be repealed, and the United States will return to a status quo where health insurance is a privilege, not a right.
But, at this point, repeal is unlikely. With President Obama’s reelection, we crossed a point of no return. States have already begun to implement major provisions of the Affordable Care Act, and governors of all stripes — including conservatives like Arizona’s Jan Brewer — are pressuring their legislatures to sign on to the program. Within a year, large numbers of Americans will begin to see concrete benefits from the law, giving them reason to support the system as a whole.
Even if a Republican wins the White House in 2016, the Affordable Care Act is likely to survive, for the simple reason that people don’t like to lose benefits. Republicans will have to accept Obamacare as part of the political landscape and move on.
Rather than pine hopelessly for an end to the Affordable Care Act, Republicans would be better served by reforming the law to suit their substantive priorities on health care. And if they don’t have those priorities, then the next few years is a good time to figure some out.