Washington, D.C. — “These people don’t understand what the government is trying to do for them,” said then-chairman of the House Ways and Means Committee Dan Rostenkowski in August 1989, after senior citizens angry over a federal health-care law booed him and chased him down a Chicago street. That law was repealed a few months later by a Democratic Congress and a Republican president who had supported it just the year before.
Everything old is new again. We are starting to hear in D.C. that today’s unpopular health-care law might be in real trouble, spelled with a capital T, as The Music Man would put it.
Noted liberal writer John Judis wrote a lengthy story in this week’s New Republic entitled “Think ObamaCare Can’t Be Repealed? It Happened Once in Australia.” By suddenly announcing last week yet another jerry-rigged delay in Obamacare’s implementation, the White House sent another signal to Congress that it expects the law to be a controversial issue in the 2014 elections, causing more anxiety for Democrats in Congress who already don’t trust the White House’s handling of the law. Many expect that the crippled HealthCare.gov website will not work for “the vast majority of Americans,” come the Obama administration’s self-imposed deadline of November 30.
Most significantly, a flurry of stories in the last week have revisited the demise of the Medicare Catastrophic Coverage Act nearly 25 years ago. That law created a host of new benefits for seniors, including a ceiling on hospital bills and increased coverage of nursing-home care and prescription drugs. But after a huge bipartisan majority passed the law in 1988, the hefty costs of the benefits arrived, along with various unintended consequences. Many seniors were happy with their existing catastrophic-insurance plans and wanted to keep them. Many of the costs became visible before the benefits were clear. In the face of growing opposition, the law’s creators pondered a host of temporary “fixes,” none of which seemed to work or placate opponents.
Sound familiar? Well, except the part about the bipartisanship. As we know, Obamacare passed without a single Republican vote and with the opposition of a significant number of House Democrats. The law was so complicated that Nancy Pelosi, then the speaker of the House, infamously declared in 2010, “We have to pass the bill so that you can find out what is in it.”
Even then, in 2010, some survivors of the Catastrophic Coverage Act debacle were unsure of Obamacare’s staying power. “When I saw this massive thing, I said, ‘Boy, if this is anything like catastrophic, they are going to be in trouble,’” former representative Brian Donnelly, a Massachusetts Democrat, told the New York Times. “It is a very good analogy.”
Republican senator Dan Coats of Indiana remembers voting for the catastrophic legislation in 1988 as a House member and then voting to repeal it as a freshman senator the next year. Voters regard their health care as a personal issue that trumps everything else, he told me. “Anything people fear will jeopardize their relationship with their doctor or raise their costs can trigger voter fury,” he said. “The missteps in Obamacare have been the same as the ones we saw back with catastrophic care in 1989.” Having said that, he doesn’t believe the odds of repealing Obamacare are high, given how much the president and his congressional allies have invested in it.
Christopher DeMuth, the former head of the American Enterprise Institute who is now with the Hudson Institute, says the biggest vulnerability of the catastrophic program was that its costs were immediately visible to its beneficiaries. Obamacare, he observes, carefully hides its costs in an intricate web of subsidies and restrictions on insurance. “But those costs are becoming more visible more quickly than many thought,” he added. “So surprises can happen.”
And then there is the matter of how close people feel they are to a political issue. Bruce Webster, an information-technology consultant who was one of the first to accurately dissect the problems of HealthCare.gov, put it this way:
How many of you know someone (including yourself) who had their existing health-insurance policy cancelled as a result of Obamacare, and who are now looking at options that are more expensive and have higher deductibles?
How many of you know someone (including yourself) who works for a business whose health-insurance coverage is either going to be eliminated or become more expensive as a result of Obamacare?
Speaking for myself, I met a friend last Thursday who has seen his health insurance cancelled. His new policy has a higher deductible and drops the dental coverage he had. He is quite upset and not likely to forget the undesired “help” the government has given him.
The number of people like my friend who will be personally affected by Obamacare in a negative way is apt to exceed, perhaps by a lot, the number of people who feel they are winners under Obamacare. And these people will probably be motivated to vote in a midterm election. If that disparity between losers and winners continues and even grows between now and the midterms that will take place just eleven months from now, that election could turn into a bloodbath for Democrats, much as the 2010 midterms were. If so, we might see — if not a full repeal of the law — something that resembles repeal forced on an unwilling White House.
After recounting the reversals a government-run health care system underwent in Australia in the 1980s (a different program has since been voted into law), Judis reached this conclusion in his New Republic essay:
From all appearances, the Obama administration seemed to believe that the mere act of getting the Affordable Care Act through Congress would ensure its survival and popularity. But now it faces the very real possibility that the Republicans, campaigning on the failure of Obamacare and flagging recovery, would win back the Senate in 2014, and be in a position to force the administration to accept changes in the Affordable Care Act that will weaken the program. Obama has already embraced modifications to the act — allowing insurance companies to bypass the exchanges and their regulations — that will hurt it. And if Republicans were to win the White House and Congress in 2016, they could simply repeal the Affordable Care Act. . . . One can only hope that the Obama administration can finally get its act together and get HealthCare.gov to work properly. And do so quickly enough so that in November 2014, the political ax doesn’t fall on Democrats’ heads.
Democrats may publicly pooh-pooh the chances of Obamacare’s suffering the same fate as the Medicare Catastrophic Coverage Act. But privately they are a lot more nervous about it than they let on. And getting more so with each passing cycle of awful news.
— John Fund is national-affairs columnist for National Review Online.