Obamacare wins? See you in 2014
By: David Nather
October 18, 2013 05:22 PM EDT
Now, let’s talk about that website.
President Barack Obama’s signature health care law is now turning into a 2014 election issue, rather than the disastrous defunding fight that led the government to close for three weeks. With the shutdown out of the way, the health care law’s problems will take center stage in a way that they didn’t while Republicans were stepping on their own message.
Obamacare was always going to be a major issue in the mid-term elections, since so many of its major pieces — the new health coverage, the online marketplaces where the coverage is available, the expansion of Medicaid, and the hated individual mandate — become real in January.
But now, Democrats will also have to talk about a federal health insurance website that barely anyone can use. Even White House spokesman Jay Carney was reduced to arguing Thursday that Obamacare isn’t just a website — after Obama has been saying it would be as easy as shopping for flat-screen TVs online.
That’s why, even though Republicans have been damaged in the short term by the Obamacare fight they picked, there’s no reason to believe the Obama administration and Democrats will have an easy time in the months ahead, according to health care analysts and political strategists from both parties.
Republicans, they say, can just let the spotlight return to the federal Obamacare website that breaks all the time — and any other implementation oopsies that happen along the way. That process is already underway, as House Republicans plan hearings on the website issues and Sen. Marco Rubio of Florida warned that there will be a “revolt” over Obamacare in 2014.
“Getting the shutdown-debt limit debate behind us allows the problems with Obamacare to resurface. Those problems haven’t gone away,” said Republican pollster Whit Ayres, who had warned GOP lawmakers that the shutdown would be a major distraction from those problems.
That doesn’t mean the debate will be unchanged, though. Republicans now have to get it through their heads that the law isn’t going away. As one Senate Republican aide put it Thursday, “We’re past that existential question.”
Democrats say they’ll always be able to remind Americans of the massively unpopular shutdown whenever Republicans try too hard to fight the law.
“Republicans thought that this was a winning issue for them and would trump public outcry over the budget and the debt ceiling … Republicans were dead wrong,” said Matt Canter of the Democratic Senatorial Campaign Committee. “The shutdown showed that voters don’t want to continue refighting the partisan battles around the health care law.”
And top GOP strategists say the party has to try harder to rally around an alternative, which they haven’t been able to do so far.
Oh, and maybe don’t shut the government down again.
“The challenge for Republicans is to make this a policy fight, not a political fight,” said David Winston, a top Republican pollster who advises the House GOP leadership. “It’s incumbent upon Republicans to come up with an alternative. For most people, going back to where we were is not an option.”
There are a few GOP alternatives, including one by the Republican Study Committee and another by Rep. Tom Price of Georgia, that use more limited measures to solve problems like covering people with pre-existing conditions. But “you can’t say there are 18 different plans. That doesn’t define the choice,” Winston said. “They need to be able to say, ‘Here’s what you have, and here’s what you could have.’ ”
Health care analysts who take the longer view play down the short-term damage of shutdown politics and the website crashes. The real bottom line, according to Drew Altman of the Kaiser Family Foundation, will be what people say when they finally get Obamacare coverage.
“Do they think they got a good deal? That’s the single most important question,” said Altman.
But that, by definition, means the White House and congressional Democrats have to make sure the early enrollment problems aren’t followed by other, more serious breakdowns when the coverage actually starts in January. Their challenge is to make sure the federal health insurance website becomes useable, just as some of the states that are running their own health insurance exchanges have largely solved their early glitches.
They also have to find enough success stories — people who have gotten their health coverage and are pleased by the experience — to counteract the comments Republicans are circulating from people who are complaining that the premiums are too high. There are people who are successfully signing up, on the federal website as well as state-run marketplaces like the one in Minnesota. But they haven’t been able to overshadow the stories of people who can’t even log in.
“Since at the end of the day, Obamacare is a marathon and not a sprint, the president and Democrats are well positioned,” said Democratic strategist Chris Lehane. But the only way to make the marathon shorter, Lehane said, is for the administration to be effective in telling the success stories.
That will be especially important for four red-state Democratic senators — Mark Pryor of Arkansas, Mary Landrieu of Louisiana, Kay Hagan of North Carolina, and Mark Begich of Alaska — who are up for re-election next year and will need ammunition to counter Republican attacks on the law. So far, they’ve stayed silent on the implementation problems — but none of them broke ranks with Democratic leaders in the fight against the GOP Obamacare defunding and delay efforts.
The National Republican Senatorial Committee is promising to go after those Democrats hard. “The Obamacare website is a disaster, but that’s only the tip of the iceberg – the real problems are with the law itself,” said the NRSC’s Brad Dayspring. “Costs continue to rise, many people are not able to keep the doctors they are comfortable with, and workers are seeing their hours cut and suffering the consequences.”
Obama administration officials and congressional Democrats are confident that they’re in a better place, at least for the short term. They all cite a poll by NBC News and the Wall Street Journal last week that found that support for Obamacare actually ticked up a bit during the shutdown — though only 38 percent thought the law was a good idea, while 43 percent still thought it was a bad idea.
Republicans have clearly damaged themselves by provoking the shutdown — and some strategists say the damage could hurt their credibility on Obamacare in the long term.
“Republicans have so severely over-politicized their assault on Obamacare over the last few weeks, that they’ve lost a lot of credibility to go after it in the future,” said Mark McKinnon, a former adviser to President George W. Bush.
But other GOP strategists who thought the shutdown was a dumb idea are breathing a sigh of relief that it’s over. They’re sure that Republicans can start focusing on congressional oversight of the law again. House Republicans are planning hearings on the website problems — likely in the Ways and Means and Energy and Commerce committees — and have already fired questions at Health and Human Services Secretary Kathleen Sebelius about the issue.
“Today’s polls are interesting, but not necessarily predictive of how they’ll look twelve and a half months from now,” said Harvard’s Robert Blendon, who studies public opinion on health care.
Even supporters of the health care law say the website problems are a valid issue to talk about — for Democrats as well as Republicans. House Minority Leader Nancy Pelosi said Thursday that the federal website “has to be improved,” and quickly.
“If the website isn’t fixed soon, it’s not just a Republican issue. Everyone’s concerned,” said Tim Jost, a law professor at Washington and Lee University who’s a vocal advocate of the law. “I don’t see this as just a political problem. I see this as a real problem for millions of Americans.”
It won’t be just the website issues that will fall under the GOP spotlight in the months ahead. House Budget Committee Chairman Paul Ryan and Senate Budget Committee Chairwoman Patty Murray are finally starting the budget negotiations that have been delayed all year, and that could be a vehicle for Republicans to suggest changes to the health care law. GOP aides say any Republican suggestions would probably focus on reining in the law’s costs.
Democrats say they’re willing to talk about potential changes, as long as the ideas are intended to help the law, not drag it down. “We’ll certainly be open to talking about ways to improve the law, as we have with every law that’s ever been passed,” said Murray spokesman Eli Zupnick.
In addition, House Speaker John Boehner has hinted he’ll force Democrats to take more tough votes on unpopular parts of the law, hoping to peel them away on issues like delaying the individual mandate. “We will rely on aggressive oversight that highlights the law’s massive flaws and smart, targeted strikes that split the legislative coalition the president has relied upon to force his health care law on the American people,” he said in a statement Wednesday.
But in the short term, the federal website breakdowns will get a big share of the attention — because they’ve been a source of anger and frustration for Democrats as well. Republicans have been circulating the comments of former Obama spokesman Robert Gibbs, who told MSNBC earlier this week that “I hope they fire some people” over the site’s numerous and constant problems.
Those kinds of comments are giving Republicans confidence that they’ll have natural traction for their warnings that the law isn’t ready for prime time. ”If anything, Republicans are going to be joining a national conversation,” said Republican pollster Kellyanne Conway. “The government shutdown will be more of a distant memory compared to the clear and present danger of Obamacare.”
Not all Republicans, however, think it’s smart for Republicans to bank on the website problems continuing, especially since it clearly did receive a lot of traffic — though that’s hardly the only source of its troubles.
“We shouldn’t put all our eggs in the glitch basket,” said Republican strategist John Feehery, a former House leadership aide. “Republicans have to be patient. They’re going to have to pick their spots, and they’re going to have to win more power.”
And supporters of the law say the aftermath of the shutdown can also be a new opportunity to introduce the public to the law’s benefits, like coverage of pre-existing conditions and new rules and benefits in the insurance people get. They still believe that, over time, the law will become more deeply rooted as low-income and middle-class Americans get health coverage.
“People don’t want to go back to the days when insurance companies could charge whatever they wanted to charge and drop you when you needed the coverage the most,” said Tony Carrk of the liberal Center for American Progress. “People want this law to work … This constant focus on repeal and defunding, I just don’t think that’s where the American people are.”
The problem, though, is that Congress hasn’t been willing to do a lot of constructive things to make the law work better. The Senate deal that reopened the government included a measure to verify the incomes of people who apply for Obamacare subsidies, but its centerpiece is just an inspector general report on the effectiveness of the procedures already in place.
And what the Obama administration really wants — more implementation money — is something House Republicans have always turned down, and there’s no sign that they’re changing their minds now.
“Now that we know it’s going to be implemented, not stopped, does the country have the ability to fix it and make it better?” asked Altman of the Kaiser Family Foundation. “Right now, you’d have to say no — not with the current Congress.”