Like guerrillas who hold out in caves long after the end of a war has been declared, leading Republicans are doing their best to undermine the implementation of the Affordable Care Act. The law, complex and imperfect, nevertheless received majority approval in both houses of Congress, was signed by the president and upheld by the Supreme Court. It represents our government’s most comprehensive effort to date to wrestle with rising health-care costs and troubling gaps in coverage. The success of the law will depend in large measure on its adoption in the marketplace, and here Republicans see an opportunity to be disruptive. Some Republican governors refuse to accept Medicaid funds to help the uninsured or to set up exchanges to make the new health market work, and some Republican senators warn leading marketers, like the National Football League, not to cooperate with the Obama administration’s efforts to explain and promote the implementation of the law.
This Republican pattern of ruthlessly putting their political or ideological interests over the national interest goes back at least to the election of 2000, when some Republican partisans were unwilling to allow votes to be properly counted in Florida and found a willing partner in the Supreme Court to deny Al Gore the presidency despite his having won the popular vote and his gains in the Florida recount. The pattern continued during the Bush years when Republican neoconservatives saw what they wanted to see in intelligence reports and intimidated doubters of their strategy to invade Iraq, and it blossomed during the Obama years with near-unanimous Republican opposition to Obama’s efforts to right the economy. Mitch McConnell’s infamous comment about making Obama a one-term president is Exhibit A of the Republicans’ determination.
The Republicans are correct: We are entering a time of maximum vulnerability for the new health law. Implementation will bring confusion, frustration and higher prices for some. But it will also bring some clear advantages that this country has tried to achieve for more than three decades. Again, Republicans are choosing political expediency over a concerted effort to improve the nation. And once again, they are are jeopardizing their long-term brand viability for short-term gains.