Democrats and their media allies are giving us a bad case of whiplash. Obamacare will work! Obamacare won’t matter! Obamacare is going to give millions of people affordable health-care coverage! Of course it’s more expensive — look what you are getting! Yes, these are contradictory spiels, an inevitable consequence of a White House is disarray, if not on the verge of panic. Depending on the spin of the moment (HealthCare.gov is fixed! It doesn’t matter if it’s fixed!), the left-leaning blogosphere twists this way and that, trying to follow the White House’s logic.
One thing we know for sure: The GOP is running against Obamacare, and hard. The GOP’s gamble is entirely understandable, and isn’t much of a gamble. Consider the problems that still loom:
The electorate is firmly opposed to the law and is increasingly disinclined to believe Obama’s promises about his health-care plan.
The Web site is still not working 100 percent.
The error rate in transmitting information to insurers is high, raising concern that come Jan. 1, people who think they are insured won’t be, according to their carrier.
Sticker shock is spreading, ignited by the realization that even the lowest-level Obamacare plan is higher on average than pre-Obamacare plans.
For a very long time, millions more will have been dropped from coverage than will have signed up in the exchanges.
Many Americans will soon discover they didn’t get to keep their insurance plan or their doctor.
The security risks (or the appearance of security risks) associated with HealthCare.gov.
The ratio of younger, healthier people to older, sicker people is unlikely to match the administration’s predictions, leading to higher costs.
Even if some of those problems turn around, others will not because they are features of the law (for the time being) — the prices, the insurance disruption and the doctors no longer available “in network.” And the gap between expectations and result is so stark that it’s hard to see how Obamacare can fix all these problems and reach its goals. James Capretta argues:
Of course, the goal for Obamacare is not just to tread water and prevent a rise in the number of uninsured. The goal is “universal coverage,” or something close to it. In 2014 alone, the administration says it wants to reach 7 million newly insured people in the exchanges. To reach that goal, the administration probably needs to sign up at least 6.5 million people for coverage in the exchanges over the period December to March (this is in addition to the 9 million they want to sign up for Medicaid). That is the equivalent of about 50,000 people per day—on top of the people who need to go through the exchanges because their current policies have been cancelled. So, realistically, if Obamacare is back on track as we are told it is, then we should be hearing about a surge of enrollment that is well in excess of 100,000 per day in December. Not even the law’s most ardent and optimistic defenders expect that to happen at this point.
The law’s fundamental problem remains as it has been from day one: success depends on large numbers of Americans enrolling in insurance plans that they would rather not purchase.
Recall that Obamacare was designed primarily to help the 15 percent of the population not insured. That was a small minority of the electorate. And the sliver has gotten tinnier since a number of those in the 15 percent couldn’t get Obamacare (due to Web site issues or affordability issues) and a number of the 85 percent (who lost coverage, doctors, etc.) who were fine before have been harmed. After a year of this, there will be more people in the “don’t like the current system” group than before Obamacare. That, in a nutshell, is the Democrats’ problem: It is making things worse for more people than does the current system.
The problem for the GOP is that it isn’t enough to repeal Obamacare now that the damage has been done. Insurance plans have been redesigned. People have lost coverage. There will be gaps in coverage. Obamacare created even more uninsured people. Repeal is not feasible (if it ever was); Republicans must come up with both a rescue plan for those adversely affected now and a longer-term solution for improving healthcare, which was the point of Obamacare all along.
So, yes, Obamacare will matter very much next year, and it is in all likelihood going to be a boon for the GOP. How helpful it is and whether it enables the GOP to capture the Senate depend in large part on what Republicans offer as an off-ramp from the current mess and what alternative route they suggest.