Why the Fight over Obamacare May Never End



Among the consequences are that Republicans will be absolutely free to continue to blame every problem anyone has with the health care system on Obamacare, without concern of producing a backlash from the law's supporters. Compare that to how they talk about Medicare, a program they've hated since the moment it was proposed. Because they know how much seniors love their Medicare, they have to pretend they would never harm a hair on the program's lil' ole head. Medicare cuts? Heaven forfend! We merely want to strengthen the program! Turning it into a voucher? Not us! We merely advocate premium support. It's supportive!

That ridiculous kabuki Republicans are forced into is what protects Medicare from the shivs they'd love to jam into its hide. But nobody is going to shout, "Take your hands off my Obamacare!" because Obamacare isn't going to be perceived as a thing you have. It's just a bunch of rules governing how other things run.

Republicans were no doubt overjoyed to see the latest Kaiser Family Foundation poll showing 19 percent of Americans believe that Obamacare has already been repealed, and another 23 percent don't know whether it's the law of the land or not. Most Americans have next to no idea what it does and how it might help them. Some commentators see that and blame the administration for not spending enough time communicating the law's benefits, which is like saying to a baseball player that the reason he's only hitting .250 is that he hasn't bothered to go the batter's box and attempt to hit the ball with his bat. They've spent untold energy and time communicating the program's benefits; I haven't bothered to count because I want to retain my sanity, but I'll bet that if you did you'd find that the president has given a couple hundred speeches, interviews, and statements about Obamacare.

The problem isn't that they haven't tried, it's that given the complex nature of the law, getting a largely inattentive and (let's be honest) ignorant citizenry to understand it is a very difficult task even for people who are good at that sort of thing, just like hitting 99-mph fastballs. Might it have been easier if the law were designed differently? Absolutely. If it were a single-payer plan, everyone would understand it. But instead, it's an extremely complex set of regulations, every one included to address a particular problem or woo a particular interest group or placate a particular ornery senator. That complexity was dictated by both the existing complexity of our health care system and political reality as the administration and congressional Democrats understood it at the time (accurately or not).

That isn't to say that Obamacare's image can't improve as we go through implementation in the beginning of next year. If you want a less gloomy view than mine, you can read Jonathan Cohn (here and here), who details some of the reasons to be optimistic about the early stages of Obamacare's implementation. It's entirely possible that if things go reasonably smoothly, people will say, "Gee, this isn't nearly as bad as Republicans said it would be." Implementation will get a lot of press coverage, and I'm sure many news organizations will do their best to help their audiences understand how the law will affect them. That will increase what people know, and also give the law's advocates another opportunity to make their case that it's a good thing. But even so, there'll be little reason for Republicans to let up on their attacks on the law. They may not be able to scream about death panels anymore, but they'll certainly blame every insurance company misdeed, rate increase, or anything else you might not like on Obamacare. That means that public opinion on it is likely to be divided for the foreseeable future, and as long as American health care is anything other than perfect, Republicans will keep telling people that whatever's wrong is the fault of that socialist Obama's big government takeover.


I think you are too pessimistic. Nothing freein the bill that i can see. Its already bending the cost curve down.

I am a 17 year old High school senior in Oakland, CA. I disagree, I understand ACA isn’t just one thing but it's different regulations and new set of rules that will change many different things and the way insurances works.

Obama has given numerous speeches trying to explain the how Obama care works but people are taking it for granted. When people realize that ACA doesn’t work like Medicare or Medicaid the people will then wonder what changes did Obama do or instead keep blaming the government for the negative changes.

Regardless of all the citizens that aren’t getting informed and the fact that the ACA is a lot of new regulations I think that many people will benefit from this. A lot of people possibly see it as a bad thing because it will increase the money paid in taxes and people don't want to pay to benefit others if it doesn't benefit them. ACA isn’t just for a certain race or gender and it will help everyone by lowering the cost of health and also by trying to increase the number of people covered by health insurance. This is a great thing because it is something everyone needs and there are many people that can’t get checked because they can’t afford it.
Overall, I understand that it is going to be a hard process and many people might see it as a bad thing and the people that benefit from it might not even understand what it is. I do think that this is going to be a really good change that might help improve the lives of many Americans.

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