Blog »

+A -A
Jame C. Capretta and Yuval Levin in The Weekly Standard: Getting There September 16, 2014

The Weekly Standard, September 22, 2014

Obamacare—or at least the version of it that the president and his advisers currently think they can get away with putting into place—has been upending arrangements and reshuffling the deck in the health system since the beginning of the year. That’s when the new insurance rules, subsidies, and optional state Medicaid expansions went into effect. The law’s defenders say the changes that have been set in motion are irreversible, in large part because several million people are now covered by insurance plans sold through the exchanges, and a few million more are enrolled in Medicaid as a result of Obamacare. President Obama has stated repeatedly that these developments should effectively shut the door on further debate over the matter.

Of course, the president does not get to decide when public debates begin or end, and the public seems to be in no mood to declare the Obamacare case closed. Polling has consistently shown that more Americans oppose the law than support it, and that the opposition is far more intense than the support. The law is built on a foundation of dramatically expanded government power over the nation’s health system, which strikes many voters as a dangerous step toward more bureaucracy, less choice, higher costs, and lower quality care. The beginning of the law’s implementation does not appear to have eased these fears, and in some cases has exacerbated them.

But opponents of Obamacare must also reckon with the reality that the goal of repealing the law and replacing it with real, market-based health reform to bring down costs and enable more people to get covered is no longer aimed at a system that exists only in theory. When President Obama won reelection in 2012, it became inevitable that some version of the law would get implemented starting this year. And it was also a pretty good bet that, despite the law’s internal contradictions and problems, it would not, as some had surmised, collapse on the launch pad. Massive federal spending authority can prop up many a teetering edifice. The surprise is not that some 6 million people or so eligible for nearly free insurance under Obamacare took advantage of the offer; the surprise is that many millions more who were eligible declined to take it.

Continue Reading…