Get this: Late last week the government announced that its online health insurance marketplace -- an e-commerce portal for millions of uninsured people in 36 states -- would soon be working, and some people were very upset about it.
You read that right. There are actually a lot of people working in politics who want the technical problems that have plagued these marketplaces to persist, so that uninsured people remain unable to purchase coverage.
And here's a modest prediction: If the marketplaces don't begin work by about the end of November, these same people will pretend to be extremely concerned for the well-being of the marketplace's intended consumers, but they'll actually be extremely pleased that those consumers will be locked out of it.
The right's reaction to Healthcare.gov's troubled rollout, and now to the prospect that it will be fixed before it becomes an existential liability to the Affordable Care Act writ large, reveals much more than the fact that conservatives really, really hate Obamacare.
The prospect that Healthcare.gov might be unfixable wouldn't have been so exciting to conservatives if the people who are meant to make use of it weren't interested. Or to put it another way, conservatives salivated over the thought that Healthcare.gov was beyond repair because they know that everything else will fall into place once it's fixed. The markets will scale up. The uninsured young, whose participation is required to create a sustainable actuarial balance, will be able to enroll easily. People will buy the insurance.
They want Healthcare.gov to fail, then, precisely because Obamacare isn't the parade of horribles they've warned about, and they know it. Which is why they're now widening their rearguard action.
Smarter conservatives saw this coming even before the administration stuck its neck out to say Healthcare.gov will be working by about Thanksgiving.
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But sometime last week it began taking hold among a wider set of Republicans -- including the political folks who vary tactics by the hour based upon the vicissitudes of cable news, rather than the known contours of the policy battlefield.
Republicans on the House Energy and Commerce Committee were on the leading edge. Rep. Joe Barton, R-Texas, and his colleagues tried to stoke a fire of panic by advancing the false charge that Healthcare.gov violates legal protections preventing the government and private entities from disclosing people's health status information.
Other Republicans settled on a less mendacious strategy. It's true that a subset of Affordable Care Act beneficiaries will see their overall out-of-pocket costs increase under the law, or be required to pay hundreds of dollars a month for first-time coverage, with no premium support from the government. Those people are coming out of the woodwork. And so Republicans are now spending as much time disingenuously bemoaning Healthcare.gov's problems as they are pretending that the Obamacare marketplaces will create more losers than winners.
If a flood of stories about "rate shock" scare people out of browsing for plans themselves, all the better. But the real backup plan, such as it is, is to pit a thin demographic -- healthy, young, middle-class, disproportionately male individuals who had cheap but crappy insurance until now and are resentful that they have to pay more -- against the newly insured, and older, sicker beneficiaries who will see their costs go down, and hope the latter don't have enough clout to prevail in a political brawl.
The right's demographic will probably be easier to mobilize. See this L.A. Times story, or David Frum's Twitter account, for a taste of the (in some cases understandable) resentment. But if Healthcare.gov works soon, it probably won't have the numbers. We've known for years that Obamacare wouldn't be immediately beneficial to everyone's bottom line -- that it would create a new financial hardship for a small minority of consumers. But first-year premiums actually came in lower than expected, which means this demographic will be smaller than anticipated. Moreover, I think the right is badly underestimating how important the law is already proving to people who were uninsurable until this month. Many of them will be happily paying thousands of dollars a year more than they had been -- because it costs $0.00 a month to apply for insurance and get turned down.
Either way, though, the strategy will run headlong into the GOP's overreach problem. If Republicans were really concerned about middle-class pocketbook issues, they'd argue in a limited way that Obamacare requires people of modest means to buy too much insurance. Pare down the definition of essential benefits somewhat or let more young beneficiaries purchase catastrophic plans, and the hit to their wallets wouldn't be so severe.
But that's not really what their game is. They want to mortally damage the law. And as such they don't care nearly as much about the dollars people will spend because ACA-compliant insurance benefits are fairly generous as they do about the dollars people will spend because they're cross-subsidizing the ill and the aged. And those are precisely the grounds to fight on if the goal is to get liberals to circle the wagons around Obamacare.
Ending insurance company discrimination against people with preexisting conditions was a huge victory for the law's authors, and they won't entertain solutions to the rate shock "problem" that threaten the ban. Expecting otherwise would be like expecting the authors of the Civil Rights Act to loosen protections for minorities in 1965 because they made lines at lunch counters too long. The only ways to stop cross-subsidization are to end community rating and allow insurers to charge sick people more money, or end the individual mandate, and let the stratum of losers opt out of Obamacare without a penalty.
Neither of those things is going to happen. The past two months proved that pretty conclusively. They also proved that Republicans badly over-promised to the law's opponents. The shutdown demonstrated just how empty the promises were. Which means Republicans can align in class war with the Obamacare discontents, but they can't credibly promise them reprieve. So time will pass, resentment will dissipate, some of those put off by the first-year sticker prices will become grateful for their benefits, and the right will be out of moves.
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