The high water mark in the Republicans’ ongoing attack on the Affordable Care Act was reached in early January. That’s when the Republican-controlled Congress finally approved a spending bill to dismantle the controversial national health insurance program and sent it to President Obama.
Senate leaders had employed obscure budget rules to force the measure past the Democratic minority, and the House with its huge GOP majority, finally powered through the legislation and sent it to the White House.
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Although Obama promptly vetoed the legislation that posed a threat to his signature health care program, Republicans declared that they had finally demonstrated after five years of effort that they could rescind Obamacare with a Republican president.
“We have now shown that there is a clear path to repealing Obamacare," House Speaker Paul Ryan (R-WI), said in a statement. “So, next year, if we’re sending this bill to a Republican president, it will get signed into law."
Republicans seemed to have the wind at their backs in their crusade to dismantle a government-sponsored insurance program that had weathered two major legal challenges that reached the Supreme Court and has come under repeated fire for incompetent management practices and excessive premium hikes and co-payments.
The program enacted in 2010 has been beset by a rash of financial and economic problems that have forced nearly half of its non-profit co-ops to go out of business and prompted insurance giants United Healthcare Humana to pull out of some of the markets. Mark Bertolini, CEO of Aetna, said massive losses have forced his company to rethink their commitment to Obamacare in 2017.
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Whit Ayres, a veteran Republican pollster and political adviser, said that Obamacare “may be in good shape politically if Hillary Clinton is in the White House, but it certainly is not in great shape economically.”
“You have numerous reports of major insurance companies basically pulling out of Obamacare,” he said. “You have other reports about how the people who are left tend to be sick people who desperately need insurance. And the reason is, that among others, the young people who are healthy are supposed to be the economic backbone of Obamacare. But the deductibles and premiums have gone up so much for healthy young people that they’re dropping out or not participating at all.”
“You have a very unstable system, and the chickens are coming home to roost now, with the fundamental structure of Obamacare that was not built to sustain such a massive program,” he added. “So I don’t buy the presumption at all that it is somehow in good shape. It has major problems that will have to be addressed by the next President and the next Congress.”
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“Repeal and replace Obamacare” became the mantra of a large field of Republican presidential candidates throughout the 2016 primary. Donald Trump and other GOP presidential aspirants scrambled to present credible plans to replace a program that now serves more than 20 million Americans, most of whom are on expanded Medicaid.
But in the aftermath of Trump’s astounding political meltdown since the mid-July Republican National Convention, the GOP is facing the prospect of a Democratic blowout in November that would permanently shatter any prospects for replacing Obamacare.
Trump is falling like a stone in many national and statewide polls and is suffering unprecedented defections from many prominent Republican lawmakers and policy experts. Just this week, Sen. Susan Collins of Maine became the seventh GOP senator to dump Trump.
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Politico reported on Friday that a small handful of moderate House Republicans engaged in tight reelection races have abandoned their anti-Obamacare rhetoric in trying to appeal to voters.
Rep. Bob Dold of Illinois, who is seeking reelection in one of the most competitive congressional districts in the country, said that “Unless there is a bipartisan solution to fix the law, I don't think we should be taking symbolic votes" to repeal it.
Lara Brown, a presidential scholar, and director of the George Washington University Graduate School of Political Management, says that terrorist attacks in Europe and the U.S. and unrest throughout the Middle East have shocked the public and dictated a change in political discourse along the campaign trail. “I think what has happened is that the presidential narrative has turned to focus more on foreign policy and less on domestic policy,” she said.
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It’s becoming clear that the air has gone out of the anti-Obamacare movement, although 2017 premium shock hasn’t quite hit yet.
Clinton, the former secretary of state, is leading Trump by as much as 10 percentage points in the latest polls. She is also showing surprising strength in some traditionally red states, including Arizona, Colorado, North Carolina, Georgia and Texas, as well in more traditionally Democratic swing states including Pennsylvania, Michigan, Ohio and Virginia. If she goes on to win big in November -- and helps carry the Democrats to a strong showing in the congressional races -- then it will be game over for Trump and the anti-Obamacare forces.
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Clinton was a strong defender of Obamacare during the primaries, to the point of scolding challenger Sen. Bernie Sanders of Vermont for suggesting a single-payer, national health care program that she argued would undercut the president’s signature legislative achievement.
Although she has often signaled a willingness to amend the program to address a number of problems, such as the inadequate “risk pools” to protect private insurers from major losses, her election would guarantee the perpetuation of Obamacare for at least another four years.
What’s more, panic-stricken Republicans will be lucky to hang onto their narrow 54 to 46 seat majority in the Senate and prevent the Democrats from making huge inroads in their majority in the House. Regardless of how the congressional elections turn out, it is now inconceivable that Senate Majority Leader Mitch McConnell (R-KY) could muster 60 votes to pass new repeal legislation.
Even the Republicans’ use of the obscure “budget reconciliation” rules to push through anti-Obamacare legislation with a simple majority would appear highly unlikely with a rejuvenated Democratic party putting up roadblocks.
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“Obamacare is only in trouble if Republicans win the White House and both houses of Congress—and probably a large Senate majority,” said Larry J. Sabato, a University of Virginia political scientist. “The chances of this for 2016 are now zero. So Obamacare has years to run before any major changes can be seriously attempted.”
Joseph Antos, a health care expert with the conservative-leaning American Enterprise Institute, agrees that from a strictly political standpoint, Obamacare is moving into a safe harbor.
“Politically, I would say that the Affordable Care Act under Hillary Clinton is safe, without any question,” he said in an interview today. “I don’t see any movement either in the courts or in Congress that would do anything that would fundamentally change what is there.”
“But there is the possibility, with Clinton as president, that there would be some improvements in some problems that I think are pretty widely recognized.”
