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McManus: That unsettled health care law

Ever since Obamacare's stormy passage in early 2010, Democrats have been waiting anxiously for the program to go into effect and hoping that a dose of reality would calm the partisan battles over the health insurance plan. Once everything was up and running, they hoped, skeptical Americans would see that Obamacare was a good idea all along — and reward the party that brought it to them.

That's looking unlikely, at least in the short run. Last week's glitch-filled rollout of Obamacare's health exchange websites, combined with Republicans' furious refusal to accept the program as what President Obama calls "settled law," confirmed something political strategists in both parties had already predicted: The war over Obamacare is far from over.

"It's unlikely that the Affordable Care Act will be widely popular until people have real experience with it — until it becomes the new normal," a leading Democratic strategist told me. "We're talking about years, not weeks or months." Nobody expected the launch of a fleet of balky websites to make an immediate difference to perceptions of the health insurance plan, not even with endorsements from icons like Lady Gaga, who managed to get the main website address wrong in her promotional tweet.

Still, the opening-day problems and the slow pace of applications for health insurance were not encouraging signs.

More important, in the long run, was the Republican Party's reaffirmation — spurred by Sen. Ted Cruz, R-Texas, and other tea party legislators — that repealing, defunding or dismantling the program remains one of its top goals.

The tea party caucus has succeeded in making resistance to Obamacare a litmus test for Republicans, and as a result, it's likely that next year's congressional election will be fought in large part over the health insurance program. The fate of Obamacare may hang in the balance.

"The 2014 election will be the Gettysburg of this struggle — the deciding battle, one way or the other," predicted Robert J. Blendon of Harvard's School of Public Health.

In the current Congress, the Senate's Democratic majority has stopped the Republican-led House of Representatives from defunding or delaying Obamacare's implementation. But if Republicans take control of the Senate next year — a prospect currently rated as a tossup — only Obama's veto will stand in their way.

And even by Election Day in 2016, Obamacare may still be a work in progress.

"If you give it three, four, five years, every experience we have is that public support will be there," Blendon said. "But you have to give it that much time." Meanwhile, Republicans will have every incentive to attack the program's shortcomings.


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