Is Obama’s legacy a health care law that hurts his party for years to come?

posted at 1:41 pm on May 3, 2013 by Mary Katharine Ham

Josh Kraushaar of National Journal ponders the implications of the impending “train wreck.” Is it Democrats’ Iraq, he wonders?

At Tuesday’s press conference, President Obama delivered an unfocused eight-minute defense of his central legislative accomplishment in office – the Affordable Care Act. In the face of intraparty criticism that implementation of his health care law will be a “train wreck,” new polls showing support for the law near all-time lows, and even the Democratic nominee in next week’s House special election calling the law “extremely problematic”– there’s plenty of evidence piling up to believe health care will be a political millstone for Democrats in 2014.

In fact, the legacy of the Iraq war to Republicans during the Bush administration offers a useful reference to how the implementation of Obama’s health care law could play out politically for his party. Like the Democrats’ partisan relationship with the health care law, support for the Iraq war was a prerequisite for being a Republican during the Bush years. Opposition from the rare gadfly, like Ron Paul or Walter Jones, nearly drummed them out of the party. Among Democrats, outspoken antipathy to the war was most intense among the base – the netroots and antiwar activists at the fringes of the party. For a while, most Democrats didn’t want to sound too critical of the war effort for risk of being painted as part of the anti-war movement.

Support for the war dropped as officials struggled to implement nation-building after the fall of Saddam Hussein. As casualties piled up and the violence worsened, the fringe position of the liberal base gradually became more palatable. No longer were war-critiquing Democrats seen as soft on national security. In the 2006 midterms, Democrats effectively campaigned on an anti-war message to take back the majority in the House and Senate for the first time in 12 years, capitalizing on war weariness. Eventually a number of Republicans split from the party to save their political hide.

A couple things. I, like Kraushaar, was pretty amazed at how bad Obama’s answer was on Obamacare Tuesday, as if it hadn’t occurred to him he might have to defend it. Also, while I don’t object to the political comparison of Obamacare and Iraq, it’s worth noting that the high level of Democratic support in the Senate for the Iraq war offered more inoculation on the issue for Republicans for far longer than the entirely partisan Obamacare vote offers Democrats.

Kraushaar also touches on something many on the ideological left might miss, which is that no matter how one feels about the Iraq war (their own passionate opposition colors their perception), a domestic issue like health care necessarily affects more people in an intimate, everyday way than a war overseas did. I say this as someone who knows many people in our relatively small military community who have sacrificed all or love someone who did, but I’m stating it as a political fact not meant to dismiss their intimate, unthinkable losses:

While the debate over Obama’s health care law isn’t a life-or-death battle, health care affects voter livelihood (and their voting decisions) like few other issues do. And there are clear signs that if premiums go up, businesses are forced to change how they insure their employees, and implementation of the law is uneven, the potential for political consequences are significant. In the 2010 midterms, Democrats suffered a historic landslide when the debate over health care was abstract. The stakes could be even higher when voters have first-hand experience with its effects. (Just look at the fevered reaction from Hill staffers affected by the law for a sampling of how intense voter anger could become.)

In both examples, the presidential sales pitch ended up being overhyped, with promises made that couldn’t realistically be achieved…

Obama’s health care law was designed to expand access to the uninsured. It’s a noble goal, if not necessarily a smart political priority. (It’s more popular to advocate for improved health care, not expanded access.) But to win support for the law, Obama claimed it would lower costs, improve the quality of care and not force anyone off their current health care plan. That’s not shaping up to be the case. Premiums are rising, employer uncertainty is growing and voters aren’t viewing the law favorably – with many not even aware of the frontloaded benefits already in place. And even on the access side, the law of unintended consequences is kicking in: Some large retail companies are cutting back employee hours so they won’t have to offer health insurance. That’s not good for the economy or health care access.

As more information, more stories about implementation, and more unintended consequences come to pass, we’ll see more examples of this— a five-minute MSNBC panel grappling with the news that “Medicaid fails almost entirely to achieve its objectives, at fantastic cost to taxpayers,” according to an Oregon study partially designed by an Obamacare architect. Watch for a preview of the arguments they’ll make for many years to come. It centers on the idea that benefits from preventive care may take years and years to see, so it’s not fair to judge any of these programs, well, pretty much ever. It’s a pretty neat set-up for advocates of spending copious taxpayer dollars on things that don’t actually help people, and a real bummer for taxpayers and the people who are supposed to be being helped. As with Benghazi and the White House’s other “fact-gathering” pursuits of justice, there seems to be no day of reckoning in sight.

The panel also frets at the end of the clip, as Sen. Max Baucus did, about the fact that Americans just don’t understand how great Obamacare is because of insufficient P.R. efforts. Until the bill’s allies realize the implementation problem is about more than a really good ad campaign, they’re dooming their baby even more certainly.


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