Obamacare’s Political Future
From the August 2, 2010, issue of NR.


James C. Capretta

July 1 was a milestone of sorts for Obamacare: It was the 100th day since the president signed the sweeping legislation into law. The Democrats who pushed it through to enactment in the most polarizing debate in years are hoping that the passage of time will be their salvation. Memories are short, they surmise, and so perhaps voters won’t dwell on the heavy-handed and highly partisan manner by which President Obama and the Democratic congressional leadership muscled the bill through its final legislative stages when they go to the polls this November. And if that’s the case, perhaps Democratic candidates for the House and Senate won’t get punished as severely as many now expect they will.

For its part, the Obama administration isn’t just sitting by and hoping such a shift in public sentiment will occur all on its own. It plans to help the process along with a massive, $125 million public-relations campaign leading up to this year’s midterm election, financed by big donors from the Democratic political orbit. In addition, the Department of Health and Human Services (HHS) has embarked on its own, taxpayer-financed advertising campaign aimed at convincing various segments of the population that the new law isn’t so bad after all, starting first with seniors. The nation’s Medicare beneficiaries recently received a mailer from HHS enumerating the supposed benefits of the new law for them — without mentioning that Obamacare will cut Medicare by nearly $500 billion over ten years.

Obamacare’s supporters are also hoping that the law’s “early benefits” — those that come into effect this year, including the requirement that insurance plans cover children up to age 26 on their parents’ policies by this September — will begin to sway voters before November. Certainly the mainstream press has helped in this regard, by shamelessly hyping these relatively minor regulatory changes — without, however, noting their costs, or the very small number of Americans who will actually benefit from them.

There is precedent for increasing public acceptance of a previously controversial entitlement expansion. In November 2003, Congress passed a new prescription-drug benefit for Medicare, and most congressional Democrats viewed it with great disdain because of its private-insurance orientation, and because they thought of the benefit as too meager and the choices facing beneficiaries as too complex. The rancor with which it was enacted poisoned the well of public opinion, and polls showed that many Americans were greatly skeptical about the program immediately after enactment. By 2006, however, things had changed. Most seniors were enrolled in one of the new drug-coverage plans, and they liked what these plans were providing for them. The insurance protection was real, and the drug plans were securing such deep discounts in the prices paid for prescription medications that everyone, beneficiaries especially, was saving money. Public attitudes shifted quickly soon thereafter, followed inevitably by a shift in political tactics by national Democratic politicians. By the 2008 election, the prescription-drug benefit was hardly mentioned by Democratic candidates on the campaign trail.

It is certainly possible that the same basic political dynamic could play out with Obamacare. But there are several reasons to think that the opposite is more likely to occur, and that opposition will not recede but intensify in coming months. While it is true that the program is a massive entitlement, specifically designed to get the American middle class fully hooked on another expansive government benefit, Obamacare also — unlike the Medicare drug benefit — creates millions of losers. Democrats riddled it with budget gimmicks and sleights of hand to create the illusion of a fully financed program; but what it really does is redistribute resources within the health sector away from those who have good coverage today. As millions of today’s happily insured citizens begin to find out that their current arrangements have been disrupted, and, in some cases, terminated, to pay for the Obama administration’s government-centric takeover, their views of Obamacare will only sour further.