Yesterday’s Supreme Court ruling upholding Obamacare’s subsidy scheme appears to mean that the law has escaped any serious threats to its existence at least until 2017, when a Republican president and Congress could theoretically still repeal it.
But all signs this morning — all outward signs, anyway — are that Republicans will continue fighting the law with everything they’ve got at their disposal.
House Republicans are still forging ahead with a separate lawsuit against Obama over the law (though it may not be resolved for years). Conservatives like Ted Cruz are still calling for holding spending bills hostage to roll back the ACA. GOP presidential hopefuls Jeb Bush, Marco Rubio, Bobby Jindal, and Cruz are all pledging to keep up the fight to repeal Obamacare — “every single word,” as Cruz puts it.
What to make of this? What’s really next for Obamacare? Three quick points:
1) For now, the Obamacare status quo works for Republicans. After the ruling, Republicans can revert to the posture that’s worked for so long: They can continue to tell the base that Obamacare is evil and that eventually it will either implode from its own flaws or Republicans will finally repeal it, while skirting the need to offer concrete health reforms of their own. It’s possible this impulse could cause intra-party fights over whether to use procedural tactics that ultimately hurt the GOP. But GOP leaders appear to have succeeded in keeping those in check, and that probably won’t change.
2) At some point, the GOP posture may have to change, though Republicans may not admit it. Jonathan Bernstein argues that the ruling means health care will now return to a normal issue, because as Obamacare becomes the health care system, repeal is increasingly unrealistic. Can that be reconciled with the pledge by 2016 GOP hopefuls to repeal it?
Well, yes. At some point the candidates — or the eventual GOP nominee — will have to present concrete reforms. One possibility is that Republicans could propose various changes to Obamacare and call them “repeal and replace.” That isn’t meant to sound glib. Republicans could in fact propose ways of pushing the health system in a more conservative direction that don’t require wiping away Obamacare, even if they don’t admit that’s what they’re doing.
3) Democrats should take continued GOP opposition to Obamacare very seriously. It has serious real-world consequences. As long as states hold out against the Medicaid expansion, it could slow the law’s efforts to realize its goal of expanding coverage. One thing this means is that Democrats should redouble their efforts to regain electoral ground on the level of the states, where future decisions about the Medicaid expansion will be made.
Also, Obamacare proponents should care about the fact that many Republicans remain deeply hostile to the ACA’s mechanisms for using government to move us towards universal health care. As Jonathan Cohn notes, there are no guarantees implementation will go well over the long haul. Success — plus time — might be just the thing to cool opposition. Meanwhile, perhaps the law’s proponents can make a better case for the vision at its core. If current opposition continues, it won’t help its long term prospects, and it will matter for our politics in general.
* OUT-OF-CONTROL BERNIE-MENTUM IN NEW HAMPSHIRE!!! A new CNN/WMUR poll finds Hillary Clinton’s lead over Bernie Sanders among New Hampshire Democrats has shriveled to 43-35, which is inside the margin of error. However, the poll also shows how un-engaged voters are at this point: only 20 percent of them have decided who they will definitely support, another sign of how little such early polling means.
* OUT-OF-CONTROL TRUMP-MENTUM IN NEW HAMPSHIRE!!! Meanwhile, a CNN/WMUR poll of New Hampshire Republican voters finds Donald Trump surging: Jeb Bush now leads Trump only by 16-11. And you have to love this: “Trump easily tops the field when asked which candidate voters think can best handle the economy.”
Scoff away, but such polling suggests Trump just may smuggle himself onto a GOP debate stage, where he could do a fair amount of damage.
* WHAT TO WATCH TODAY: Obama is heading to Charleston to deliver a eulogy for shooting victims. Meanwhile, the Court could release rulings on same-sex marriage or on a major EPA rule, which could have ramifications for future court battles over climate change regs. The news never stops!
* CONSERVATIVES TARGET COURT AND 2016 GOP HOPEFULS: Reuters reports that in the wake of yesterday’s pro-ACA ruling, conservative judicial activists are gearing up to pressure GOP presidential candidates to take clear stands on the type of Supreme Court justices they will nominate. As one activist puts it: “Each candidate will have to do something to show the base how they will avoid appointing another Roberts.”
If the Court declares a Constitutional right to gay marriage, which could happen as early as today, the cries of betrayal — and the pressure on 2016 Republican hopefuls to detail how they’ll avoid appointing another traitor to the Court — may grow louder.
* REPUBLICANS DEBATE TARGETING ACA WITH ‘RECONCILIATION’: Politico reports that some Republicans still want to use the tactic known as “reconciliation” to force a simple-majority Senate vote to undermine the ACA. Not all Republicans agree:
Rep. Tom Cole, an ally of Speaker John Boehner’s, said the party should focus on reforms “you might be able to talk the president into,” such as changing how Medicare benefits and Social Security cost-of-living adjustments are doled out. “To me it doesn’t make much of it point,” Cole said of using reconciliation to repeal the law.
Of course, this would require legislating with an eye towards actual give and take, so…
* OBAMACARE IS IN THE CLEAR — FOR NOW: National Journal’s Sam Baker notes that the main lingering existential threat to Obamacare is the possibility of Republicans repealing it after winning the White House while keeping control of Congress:
Now, Obamacare is out from under the shadow of major harm at least until January 2017 — by far the longest such stretch it has enjoyed….In 2017..some 24 million people will likely be covered under Obamacare’s insurance exchanges, and another 12 million under its Medicaid expansion. The bigger that number gets, and the longer Obamacare stays the law of the land — even if it remains politically unpopular — the harder it’ll be for elected officials to take away those benefits.
I’d only add that continued GOP opposition could slow down Obamacare’s success in expanding coverage, especially if few new states opt in to the Medicaid expansion.
* ON OBAMACARE, ‘CONSERVATIVE NIGHTMARE HAS COME TRUE’: Paul Krugman responds to the ruling by going (again) over all of the evidence that the Affordable Care Act is working. Conclusion:
You might wonder why a law that works so well and does so much good is the object of so much political venom — venom that is, by the way, on full display in Justice Antonin Scalia’s dissenting opinion, with its rants against “interpretive jiggery-pokery.” But what conservatives have always feared about health reform is the possibility that it might succeed, and in so doing remind voters that sometimes government action can improve ordinary Americans’ lives….Obamacare has survived, it’s here, and it’s working. The great conservative nightmare has come true.