Republicans Maintain Hard Opposition to Obamacare at Their Own Political Peril

 The political struggle over Obamacare has reached a critical inflection point as real events have overtaken its opponents’ basic arguments.  That opposition has always drawn on, and encouraged, doubts about the public’s real interest in a federal guarantee to health insurance and their tolerance for a mandate to enforce it.  After the program’s fitful start, it is now clear that large numbers of Americans are prepared to spend the considerable time and money required to sign on. The Rand Corporation estimates that 9.5 million people who had no coverage a month or a year ago now do, thanks to the Affordable Care Act (ACA).  I also analyzed the data and found that the newly-insured number at least 7.8 million and as many as 10.9 million.  And if the governors and legislatures in 24 states had not inexplicably turned down the ACA’s Medicaid expansion – a decision three of those states are reconsidering -- the total number of newly-insured today would range from 11 million to 14 million.

            These numbers create a political inflection point, because the program’s demonstrated appeal renders it virtually impossible to repeal.  Arguing against a new federal benefit is an easy political challenge for conservatives.  By contrast, withdrawing a benefit that millions already depend on is, at best, a herculean task.  Just try to imagine any future Congress or President actually withdrawing practical access to medical coverage from millions of moderate-income families, millions of young adults covered by their parents’ policies, and millions of more people with preexisting medical conditions. 

            This political inflection point will strengthen not only as more people enroll, but also, and even more important politically, as Obamacare generates benefits for everyone else.  To begin, surveys show that several million people would like to change jobs but stay where they are, out of concerns about losing their healthcare coverage.  Now, they can do as they like – and the enhanced labor mobility should help the economy.

            More important, by enrolling large numbers of previously-uninsured people, Obamacare should slow increases in everyone’s insurance premiums -- or even lower premiums.  As countless studies have shown, most people without coverage get their medical care in emergency rooms.  Since they usually cannot pay the bills for that care, hospitals pass along those costs through higher charges on everyone else, which in turn leads to higher insurance premiums.  The ACA will not only relieve some of those direct pressures on premiums; its mandated coverage also will generate more income for insurers, further easing upward pressures on premiums.

            This would be very good news for the American economy.  Over the last decade, healthcare coverage has been the single, fastest-rising cost for most U.S employers.  But as globalization intensifies competition, many of those employers find themselves unable to pass along their higher healthcare costs by simply raising their prices.  Their only recourse, as I have written many times, has been to cut other costs – beginning with jobs and wages.  In the end, therefore, the ACA could contribute to broader gains in employment and incomes – and that could produce a political inflection point that could support political realignment.

This post was originally published on Dr. Shapiro's blog