Can Obamacare Survive?

President Obama sees himself following in the footsteps of the creator of the modern Democrats, Franklin D. Roosevelt, who launched the “New Deal” in the 1930s to protect the interests of working and middle class Americans.  Among numerous other programs, Roosevelt’s New Deal included Social Security for the elderly, a massive program of public works for the unemployed, subsidies for farmers and government recognition of labor unions to raise wages for private sector workers.  Shortly after Obama’s 2008 election, Time ran a cover story picturing Obama as the next FDR with the title “The New New Deal.”


President Obama and his advisors clearly had ambitions to put together a program to put the country back to work, protect Americans’ retirement savings, restore the health of financial markets, alleviate inner city poverty, reduce global warming  and, as he famously told “Joe the Plumber” during the 2008 campaign, “spread the wealth around.”  The centerpiece of Obama’s domestic program was universal health insurance, passed on a party-line vote.

He had hoped that his health care plan would prove as popular and enduring as Social Security.

But the political bad news about his signature program, the 2010 Affordable Health Care Act, AKA Obamacare, just keeps on coming.  First, Republicans used public anger against the program to help win a majority in the House of Representatives in 2010.  Then, the roll-out of the program’s federal website to allow Americans to sign up was so seriously flawed that none of its goals were met and the deadline for enrolling had to be extended.  A majority of states, usually those with Republican governors, refused to build their own state health care exchanges, thus putting even more burdens on the federal web site, which crashed on its opening day of October 1, 2013.  The standards for required “essential health benefits” issued by the Department of Health and Human Services meant that over three million Americans had their low-cost plans cancelled.  In 2013 and 2014, the “mandate” that businesses with more than 50 full-time workers purchase health insurance for their employees was delayed until 2015.  In early February, the non-partisan Congressional Budget Office published an analysis estimating that the program could possibly cost Americans roughly two million jobs – at a time of lingering unemployment.


While the technical problems of the federal web site have largely been fixed, not enough Americans are signing up and Obamacare remains deeply controversial.

Samuel Lubell, who was probably the best political reporter in the Roosevelt years, wrote toward the end of President Truman’s tenure: “To solidify itself permanently in American life the New Deal needed at least one Republican victory.”

Sure enough, the Republicans won the presidency the year Lubell wrote those words by nominating the great World War II hero Dwight (Ike) Eisenhower.  As the first Republican president elected since the 1920s, Eisenhower tried to avoid political conflict.  In domestic policy, Ike wrote in his memoirs that he rejected both the far left and far right and sought “to achieve a balance which could assure individual liberty in an orderly society.”  As historians Robert Marcus and David Burner wrote, “He stabilized the New Deal, neither extending it nor cutting it back, therefore making it part of the mainstream.”  Once the New Deal survived a Republican administration, its basis was secure going forward.  Since the Eisenhower Era, republicans candidates who ran on a platform of making Social Security voluntary like Barry Goldwater in 1964 lost in landslides.  As Ike himself wrote in a letter to his brother: “Should any political party attempt to abolish social security, unemployment insurance, and eliminate labor laws and farm programs, you would not hear of that party again in our political history.”

So Lubell’s principle almost certainly applies to Obamacare: for it to become part of the political mainstream, his health care reform would need to survive at least one Republican administration.


What are the prospects that Republican acceptance of Obamacare could grow?  At the moment, they’re not very good.  During the 2012 Republican primaries, every single candidate promised that they would either sign a bill passed by Congress to repeal Obamacare or, if Congress didn’t act, use their executive authority to either de-fund or gut the program through waivers that would allow every business to opt out of it.  And no likely Republican candidate for 2016 has yet endorsed keeping Obamacare.  (Full disclosure statement: as a self-employed consultant, I am a beneficiary of the California state health exchange created by Obamacare.)

The massive exit poll of over 30,000 actual voters done by the networks on Election Day in November 2012 showed a nation highly divided along partisan lines over Obamacare.  In fact, the voters’ views on Obamacare were identical to their party registrations and vote: 92% of Democrats voted for President Obama and 92% of the voters who favored expanding his health care program also backed President Obama.  By contrast, 93% of Republicans voted for Mitt Romney as did 93% of the voters who said they favored a “complete repeal” of Obamacare.  In short, less than 20% of rank and file Republican voters favored keeping any part of Obamacare.  And only 44% of all voters favored keeping or expanding Obamacare, as opposed to the 49% who favored a partial or full repeal.  Nor have things gotten much better since 2012:   the health care reform has not gotten over 50% in any non-partisan poll over the last two years.


So, a new Republican president would be under tremendous pressure from his or her own base to repeal Obamacare.

A comparison can be made with Obamacare to Lyndon Johnson’s “War on Poverty.”  The basic LBJ program of welfare payments to (mostly) non-working single mothers proved so unpopular that Republican presidential candidates ran against it for years with President Reagan scoring points for attacking the fraud of “welfare queens” who received multiple checks from the taxpayers.  Basic welfare provoked such a backlash that a Democratic president, Bill Clinton, was forced to work with Republican House Speaker Newt Gingrich to sharply curtail the program.  The contrast with Social Security, which enjoys bipartisan support, is obvious.

President Obama would be well-advised to cooperate with Republicans after the 2014 election to fashion a “reform-and-rescue” legislative package that could help create some bipartisan support for his reform.  If not, his signature program will remain highly vulnerable to political change.


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