One way to interpret everything going on surrounding the Affordable Care Act (ACA) since the government re-opened in mid-October is that health care has finally returned to being a normal issue in U.S. politics.
That is, between the already well-advanced transformation of the old system, and the plain fact that many people are now getting benefits that repeal would strip from them, the long “repeal” campaign is dead. It was probably dead some time ago, but now there’s really no question about it.
Still, health care is not going to disappear as an issue. Congressional oversight into how the federal-run exchanges are working is obviously more intense when they’re new and working poorly than they’ll be in the future, but this is what normal Congresses do: exploit administration screw-ups for political gain. Meanwhile, Greg Sargent is reporting that Democrats are using Medicaid expansion against GOP governors up for reelection in 2014 who passed on benefits for their citizens (and their hospitals and other providers). That too, is mostly just normal politics.
For years now, we’ve thought about Obamacare in terms of whether it would pass, and then whether or not it would actually be implemented. That fight is over. There still might be a few real skirmishes, especially if HealthCare.gov problems continue, but for the most part they’re going to fade.
That doesn’t mean that health care won’t be an issue. Expect, for example, Republicans to eventually fight over subsidy levels (and, perhaps, both parties to try to refashion subsidies to avoid perverse incentives on earnings). Expect, too, Republicans to eventually try to reduce ACA-connected taxes. There’s been some of that, but so far it’s mostly been restricted to things that could be outright repealed. Expect, too, plenty of oversight by this and future Congresses over all phases of it. After all, there’s more to oversee now.
The point is that even as the debate about “Obamacare” eventually fades away, we shouldn’t expect health care to vanish as an issue. Indeed: expect it to be more central to U.S. politics going forward.