The Obama administration is worried about deeply dug-in resistance to its health-care agenda, and those worries have been compounded by its depleted political capital — most voters still disapprove of the health-care law, and the president’s approval–disapproval spread has collapsed by 18.6 points since his reelection — and so it has done what it does when the going gets tough: make a speech. The main difference this go-round is that the president commissioned Bill Clinton to make the speech on his behalf rather than deliver it himself, which is perhaps an indicator that Barack Obama no longer believes that he is his own best advertisement. President Clinton was President Clinton, meaning affable, glib, and equivocal.
President Clinton conceded that there are problems with the misnamed Affordable Care Act, suggested a few corrections, and went so far as to use the phrase “unintended consequences,” which, for anybody who comprehends the full meaning of the idea, counsels against ACA per se as well as most other federal efforts to impose political regimentation on the economy or subsectors of it. But being unwilling or unable to accommodate that insight, President Clinton instead made a faux-pragmatist argument that the country would be better off if those who support the ACA and those who oppose it agree on an effort to implement the law in an orderly fashion rather than continue to oppose it.
Such calculation is excessively admired by those who swoon for the cleverness of Bill Clinton, not least among them Bill Clinton, but it will take a good deal more than rhetorical cleverness to rescue the U.S. health-care system from Democrats’ attempts to rescue it. But we will concede to President Clinton one point, and urge elected Republicans to do the same: The system that preceded the passage of the ACA was a bad one, one in need of reform, and Republican efforts to resist needed reforms on the theory that we enjoyed “the best health-care system in the world,” as they endlessly put it, were misguided. Not as misguided as the architects of the ACA, which will preserve many of the worst features of the old system and supplement them with untold expenses and bureaucratic horrors.
In addition to unintended consequences, the ACA was marred by “drafting errors,” President Clinton suggested. By this we take it to mean the fact that the law does not empower the Internal Revenue Service to levy fines on Americans residing in states that have chosen not to establish so-called exchanges of their own under the act — fines that President Obama intends to order, law be damned, and that the IRS, always eager to comply with Democrats’ priorities, intends to execute. In August, Oklahoma’s legal challenge to the administration over the IRS rule cleared its first major legal hurdle when the federal district court refused the Obama administration’s demand to have the lawsuit thrown out. The case will now proceed. What President Clinton dismisses as a “drafting error” is in fact the letter of the law, and far from a trivial oversight. The former president is of course famous for his ability to explain away or minimize unpleasant realities, but Oklahoma is confident that it knows what the meaning of “is” is.
On the substance, President Clinton was unpersuasive. The major claims of the ACA’s supporters — that it will result in near-universal coverage, that it will improve the quality of care, that it will control costs, that people happy with their coverage can keep it — run the gamut from documented falsehoods to unsupported theory.
But this speech was not really about relitigating the details of the ACA. It was one more attempt to close the door on the political dispute at the heart of the health-care debate and to foreclose democratic redress. Congress makes laws, and Congress can repeal laws — there is a reason that Congress keeps meeting year after year. Whether the issue is global warming, abortion, or health-care reform, Democrats reliably seek to declare the debate concluded and the issue dead when it clearly is anything but.
Opposition to the ACA remains a lively issue, precisely how lively to be determined in the coming fight over defunding the ACA in the fiscal showdowns later this year, in the 2014 and 2016 elections, and perhaps even beyond. Republicans should continue to press for intelligent health-care reform, whether that means repealing Obamacare root and branch or replacing it piecemeal. It will be a dead issue when the American people say it is a dead issue, and not before, the gravitas of Bill Clinton, such as it is, notwithstanding.