Opponents of the Affordable Care Act — well, the ones who depend on voters to stay in office — have always walked a fine line in their spirited fight against the law.
Sure, a congressional coalition, which is almost exclusively Republican, regularly challenges all aspects of Obamacare. In recent years, the U.S. House of Representatives voted dozens of times to repeal the law, fully knowing that their votes were little more than showboating. It was a safe way to remind their supporters that, yes, by golly, we still despise President Obama’s health-care reforms. And because a repeal wouldn’t survive the Senate or the president’s veto pen, House members never worried about owning the consequences of their opposition.
These same politicians happily cheer on legal actions against Obamacare. They pouted in 2012 when the Supreme Court ruled the law was constitutional. They celebrated the recent Hobby Lobby decision, which chipped away at mandates on contraceptive coverage.
Meanwhile, Republican governors, including Alabama’s Robert Bentley, played politics with Obamacare, refusing to allow their states to take part in the policy, even though the feds picked up the vast majority of the costs.
Oh, we don’t doubt that most of these politicians truly loathe Obamacare. Even if it was birthed in one of their hallowed shrines — the right-wing Heritage Foundation — and first implemented under a Republican governor, Mitt Romney in Massachusetts, today’s Obamacare opponents would rather it not be the law of the land.
What’s seemingly lost is the political skill to make the best of what’s available. Governors can dislike the policy while still putting it to work for their state’s residents; some have done just that. Republicans in Congress can dogpile Obamacare while at the same time sell themselves as the grownups capable of fixing the flaws in the Affordable Care Act, and make no mistake it needs some repair work.
When ideology reigns supreme, when an army of far-right activists doesn’t allow any breathing space for compromise, and when deep-pocketed funders of these politicians won’t tolerate dissent, elected Republicans find themselves handcuffed. The best they can do is fire legislative duds mixed with red-faced rhetoric at Obamacare.
And what happens if all this posturing mixed with legal filings results in the death of Obamacare? What then?
Opponents will be like the dog who finally caught the truck he was chasing. What do I do now, the dog and the anti-Obamacare congressman ponder?
They might soon find out.
On Tuesday, a federal appeals court in D.C. invalidated federal health insurance subsidies for citizens living in states that didn’t create a health exchange. Count Alabama in that number, meaning health insurance for 83,000 Alabamians is in jeopardy if the court’s ruling stands. (On the same day, another federal court ruled the opposite way on subsidies in non-exchange states. The Supreme Court will surely have the final say.)
If Obamacare is gutted, then the cheap political posturing will take a toll on those practicing it. A majority of Americans may be wary of Obamacare in general. Goodness knows, the Obama administration has done a fairly pathetic job selling its assets. Yet, while most people don’t like change, they also don’t like losing stuff.
If Obamacare goes away, so do rules that prevent insurers from denying coverage to those most in need of it. If Obamacare goes away, so does the option of allowing children to stay on their parents’ plan until their mid-20s. If Obamacare goes away, so do rules that put a priority on preventative health care. If Obamacare goes away, the ranks of the uninsured go back up, which will be a drain on the entire economy. If Obamacare goes away, we’ll return to the dog-eat-dog system that made U.S. health care the model for spending the most and getting the least.
Nobody wants any of that.