The campaign against Obamacare began as a campaign for self-interest. Obamacare, conservatives promised, would raise your taxes, take away your doctor and possibly put you in front of a death panel. The fight to keep it from passing was a fight to keep bad things from happening.
Take Ted Cruz and Marco Rubio's effort to shut down the federal government unless the Obama administration agrees to defund its signature piece of legislation. If they managed to gather enough support to make good on the threat, the result would be a painful government shutdown that the public would — rightly — blame entirely on the Republican Party. They would've hurt their constituents and their chances of retaking the Senate majority in 2014.
"If I thought this would work, I would support it," writes my colleague Charles Krauthammer. "But I don’t fancy suicide. It has a tendency to be fatal."
In the states, Republican governors are saying no to billions of dollars in Medicaid money (and, in a number of cases where they said "yes," their even-more conservative legislatures have said "no" on their behalf). That cuts them off from much-needed funds and cuts their poorest constituents off from free heath insurance. Moreover, it means their safety-net hospitals lose money they were relying on to survive — forcing devastating cuts to care. The result is a poorer state, worse-off residents and a health system under terrible financial stress. But at least they've taken a stand against Obamacare!
Then there's the emergent campaign to persuade conservatives (and everyone else) to doom Obamacare by refusing to accept its offer of free or subsidized health insurance and instead pay the fine and go without coverage. The organizers, who Sarah Kliff interviewed here, realize they can't argue that no health insurance is better than free health insurance. So they're falling back on classic welfare-shaming strategies. “I like that there is still a stigma [around Medicaid]," said Abigail Nobel, a Michigan Tea Party activist.
The campaign will likely fail to make a dent with the broader public. But it might be convincing to some hardcore conservative activists, who will go without health coverage they otherwise would have had. And then some of them will get sick, or hurt — and then what?
Over the past couple of years, Republicans have responded to minority status by adopting more extreme political tactics. Chief among them is hostage taking: threatening to shut down the government, or breach the debt ceiling, if they don't get their way.
But now Republicans have taken themselves hostage. They're threatening to hurt themselves and their states and their voters and their most committed activists if Democrats don't give them their way on Obamacare. It's evidence of their extraordinary dedication to the cause, but also to their increasingly extreme view of how American politics works.
But behind all of it is a mounting desperation. Obamacare beat a filibuster. It beat the right's legal challenge. Its namesake beat the Republican Party's nominee for president. Come 2014, it will start helping millions of Americans afford health insurance, and come the 2016 election it will have been delivering health care to tens of millions of Americans for almost three years. That's not the kind of program that just goes away in American politics.
And so Republicans are desperate to stop it from going into effect in October, and from working smoothly after that. But desperation doesn't always lead to good strategies.