The Iraq War and the Affordable Care Act

Philip Klein argues that the Iraq War made the Affordable Care Act possible, as the backlash against it created the foundation (in 2006) for the large Democratic congressional majorities that (after 2008) passed the coverage expansion law.

One could go further. Klein makes reference to Howard Dean’s 2004 presidential campaign, during which the Vermont governor offered a coverage expansion proposal that was far more modest in scope than the ACA. One reason the Dean proposal was relatively modest is that the conventional wisdom was that voters would resist a substantially more expensive proposal. Barack Obama’s 2004 U.S. Senate campaign was fueled in large part by donors and activists who had been part of the Dean effort, many of whom went on to work for Obama in various capacities. Obama came to prominence in part due to his articulate and forceful opposition to the Iraq War. And the Iraq War may have changed the fiscal conversation, as its cost undermined Republican claims of fiscal rectitude, making it more difficult for conservative lawmakers to make the case against the creation of an expensive new health entitlement. 

More broadly, it is not unreasonable to suggest that the Iraq War “damaged the GOP brand,” and particularly the party’s reputation for competence. The party’s relative weakness in 2012 — yes, the election was not a blowout and the state of the economy may well have favored the incumbent president, but the erosion of Republican support in states like Virginia and Florida was worrisome all the same — no doubt had something to do with the lingering effects of the Iraq War. 

Reihan Salam — Reihan Salam is executive editor of National Review and a National Review Institute policy fellow.

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