Are Democrats Starting to Regret Obamacare?

Retiring Sen. Tom Harkin, the Democratic chairman
of the Senate Health, Education, Labor and Pensions Committee,
which did much of the heavy lifting on

early drafts
of Obamacare, now thinks that passing the
law in its current form was a mistake.

The system created by the law “is complex, convoluted, needs
probably some corrections and still rewards the insurance companies
extensively,” he
told
The Hill. “We had the power to do it in a way
that would have simplified healthcare, made it more efficient and
made it less costly and we didn’t do it. So I look back and say we
should have either done it the correct way or not done anything at
all.”

What would have been the “correct” way? Single payer, Harkin
said, or at least the inclusion of a government-run insurance
plan—widely known as a public option. Harkin tells The
Hill
that when Democrats controlled both chambers of Congress
in 2009 and 2010, they had the votes necessary to pass those plans
into law.

In some sense, this is just a revisionist liberal fantasy.
Obamacare passed in the complex, insurance-industry friendly form
it passed in because it was the only form that could secure enough
votes, and even then only barely. Moderate Democrats were deeply
concerned about the possibility of appearing to support a
government takeover of the insurance industry, which a single-payer
plan would have done, and which a public option would have taken a
step toward. The health care industry groups—doctors and hospitals
and insurers—whose support the White House believed was critical to
passing the law would not have backed any such plan. Instead, they
would have spent hundreds of millions loudly opposing it. Obamacare
was either going to pass in a form that looked essentially like the
one it passed in, or it was not going to pass at all.

Yet Harkin’s comments also suggest a dawning realization on the
part of at least some Democrats that the law has created huge
political problems for the party. Harkin isn’t the first prominent
Democratic legislator to express regrets about the timing and
construction of the law in recent weeks. At a National Press Club
appearance last week, Sen. Chuck Schumer (D-NY), also complained
about prioritizing the health care law in 2009. Democrats “blew the
opportunity” they had when they held complete control of Congress
and “put all of our focus on the wrong problem—health care reform,”
he said.

Keying off of Schumer’s remarks, New York Times opinion
contributor Thomas Edsall looks at the
ongoing political fallout
from the health care law. Polling
data has consistently shown that more of the public opposes the law
than supports it, and in the months since the major coverage
expansion kicked in, more people now say that the law is making
things worse for themselves and their families. Of the 28
Democratic senators who voted for the law, 28 are now out of
office. There’s historical precedent for all this too. Edsall notes
that the failed attempt to pass produced similar political fallout
for Democrats, who saw mass defections of middle class white voters
and seniors.

Edsall also points to a column by political analyst Charlie
Cook, who argues that Obamacare is the defining feature of the
current Democratic party. The law has “framed where the Democratic
party is,” according to Cook. Judging by the results of last
month’s midterm election, it has not framed the party in ways that
are politically beneficial. And party members know it: a majority
of the Democratic House candidates on the ballot this year did not
express clear support
for the law.

Much of the Democratic party is still standing behind Obamacare,
of course, though they tend to defend it on its merits rather than
on its political benefits. Democratic House Minority Leader Nancy
Pelosi’s
response
to Schumer: “We came here to do a job, not keep a
job.” That’s an implicit admission that the politics of the law are
not so good.

Even Democrats who believe the political hit is worth the policy
gain should be concerned: It will be harder to maintain the law
without political victories to continue supporting it, especially
if it keeps underperforming. No, the law has not
imploded or collapsed under its own weight, but its rollout was not
smooth, and enrollment in insurance is now projected to go at a
notably
slower pace than originally expected
 for the next several
years.

The complexities of the law that Harkin complained about, and
the corrections he says are needed, make the ongoing task of
managing the law even more challenging. Witness the headaches
caused by the administration’s decision to auto-renew health plans
for those covered through the exchanges: The move will bolster
enrollment numbers, but is also likely to leave many enrollees in
plans with premiums that rise sharply and unexpectedly. That
possibility has in turn given rise to
proposals
for even more drastic and potentially disruptive
technical tweaks.

None of this is likely to make the law more popular with the
broader public, which will in turn make it even harder to sustain
politically. Indeed, compared with the years prior to President
Obama’s election, the American public is now significantly less
likely to say that it is the job of the federal government to
ensure that all Americans have health coverage.
According to Gallup
, support for the federal government
ensuring health coverage generally hovered around or above 60
percent throughout the Bush administration, rising to a peak of 69
percent in 2006. But since 2009, a majority of the public has said
that coverage is not a government responsibility. The percentage
who believe it’s not the government’s job rose from 2010 through
2013, hitting 56 percent, but has dropped back somewhat in the last
year. But the numbers are still strikingly different from where
they were less than a decade ago, with 52 percent saying it’s not
the federal government’s job to ensure coverage; only 45 percent
say it is.

In the age of Obamacare, it’s not merely that Americans have
lost interest in this particular health law. They’ve lost interest
in the larger project of government-managed universal coverage.
Which suggests that Harkin may be half right in his political
analysis, and too hopeful, even in his regret: Yes, it was a
mistake to pass Obamacare as it is—but it may have been a mistake
to pass it any form. 

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