Amy Walter of the Cook Political Report has a smart piece on the role of Obamacare in the 2014 election.
[T]here are plenty of Democrats who are worried that the roll-out will fall flat, or worse.
In an informal poll of Democratic insiders, many of whom shepherded Democrats through the dismal 2010 elections, almost all voiced concern about the potential for the issue to hurt Democrats in 2014.
“It is a concern that many of us have voiced,” said a prominent Democratic pollster.
“It is the question,” said a Democratic House strategist, “no one really knows.”
The reasons are obvious: the cost, paperwork, loss of existing health insurance and the parade of unintended consequences are finally going to be felt, and based on recent announcements (premium cost hikes, unpreparedness to roll out small-business features), things don’t bode well for the crowd that was saying that the public would grow to love Obamacare over time. As Walter notes, “There’s also the potential for a very chaotic operational process for consumers. Cost and implementation are just two of the things on which voters will judge ACA. Other things include whether the plans are comparable to what many people have (e.g., are people going to find that they are paying more for less), availability of providers, and quality of care.”
She concludes that the problem is especially acute for Senate Democrats who “have never had to defend their ‘yes’ votes in an election year”; but there are also 10 vulnerable Dems in the House — a hindrance to Democratic aspirations to take back the majority.
The 2014 election would seem to be an ideal time for Republicans to elevate Obamacare and nationalize the election. This would require: 1) a short but compelling accounting of broken promises and ways in which the law is not solving its mission (access to affordable health care); 2) a commitment to hold off on implementation (first do no wrong, as they say) and 3) agreement on the alternative. The last item cannot be overemphasized. As long as the GOP simply harps on Obamacare horrors, the other side will raise the bogeymen of denial of coverage for preexisting illness, lack of insurance for the poor and destruction of Medicare. The Republicans have to respond with something other than “That’s silly.”
Four Republicans came together for the Gang of 8 on immigration reform. Now Republicans need a small but similarly committed group to work on a GOP alternative to Obamacare. I would suggest including a governor who has firsthand experience with Medicaid fraud and abuse (either Wisconsin’s Scott Walker or Virginia’s Bob McDonnell); an experienced medical professional such as Rep. Tom Price (R-Ga.); someone like Sen. Orin Hatch (R-Utah), who has already put forth compelling ideas for reform; and a conservative with solid credentials who can get buy-in from the right-wing of the party, perhaps Sen. Pat Toomey (R-Pa.) or Sen. Ted Cruz (R-Tex.). Together they should agree on a plan that preserves protection for preexisting illness, delivers better and cheaper care for Medicaid recipients, and uses consumer choice and market forces to create a functioning market for health insurance.
Absent this sort of agreement, another election will come and go without the issues of Obamacare repeal and replacement having been joined. That is an issue about which the GOP base is certainly going to be enthused. It is not dependent on the vicissitudes of the economy, and it lends itself to a broader critique of the liberal welfare state’s expansion and phony Democratic moderates’ complicity in the same. And, if the GOP is correct, replacing Obamacare will offer the promise of relief to employers and an end to hiring stagnation. What’s more, the existing law remains very unpopular. How often do good policy, good politics and majority support coalesce on an issue friendly to conservatives?
Republicans should understand that you never want a serious crisis like Obamacare to go to waste.