Republicans couldn’t repeal it when they had the chance, and now even Republican legislatures are acquiescing to the expansion of Medicaid.
A conservative friend objected to Washington Post columnist Greg Sargent’s contention that “the GOP has essentially been routed in the Obamacare wars.” Sargent’s assessment was spurred by the GOP-controlled legislature in North Carolina agreeing to expand Medicaid coverage to as many as 600,000 more people; the federal government covers 90 percent of the cost of Medicaid recipients.
Even if the GOP wasn’t routed, the Democrats won some big and lasting victories because of their passage of Obamacare. Yes, Obamacare no doubt played a big role in the GOP waves of 2010 and 2014, and I concur that most Americans don’t feel any benefits from the passage of Obamacare. Perceptions of the law split along partisan lines, with the favorable responses starting to overtake the unfavorable responses in 2017. (Note that 36 percent of Republicans support allowing children to remain on their parents’ plans until age 26.)
But Democrats got a lot more Americans covered under Medicaid by passing Obamacare, or its formal name, the Affordable Care Act. When Obamacare passed in March 2010, about 47.2 million Americans were enrolled in Medicaid. As of November 2022, 84.8 million individuals were enrolled in Medicaid. Separately, the ACA established Health Insurance Marketplaces with subsidies, who had enrollment of about 8 million or so in 2014, projected to surpass 16 million this year.
For millions more Americans, having all or significant portions of your health-care bills paid for by the federal government is the new normal, and they will vigorously oppose any attempt at repealing those expansions.
Yes, the GOP got rid of the individual mandate, but the inability to fully repeal and come up with a replacement during the two years that the GOP had the White House, Senate, and House was deeply demoralizing for conservatives.
The task was always going to be politically difficult, but it was perhaps doomed from the start by a president with only the vaguest understanding of the issue. President Trump complained, on February 17, 2o17, “Nobody knew health care could be so complicated.” After John McCain sank the “skinny repeal” bill, Trump’s subsequent strategy was to promise he would unveil a terrific new plan in a few weeks, and it was forever a few weeks away. And when Democrats won control of the House of Representatives in 2018, everyone knew the limited window for repeal had closed.
It was the ultimate demonstration that the Republican position on Obamacare was primarily driven by reflexive animosity to Obama instead of a consensus about what alternative policies should replace it.
The rollout of Obamacare couldn’t have done much worse, but after 2014 it was old news. In the 2016 cycle, Trump brushed aside the GOP orthodoxy on entitlements and declared he wasn’t going to touch Medicare or Medicaid. And now it’s hard to find a prominent Republican who is willing to even broach the subject — and if a GOP presidential contender does, Trump will attack them for it.
So, yes, Obamacare was a key part of the GOP midterm landslides in 2010 and 2014, but it didn’t sink Obama’s reelection bid, and Republicans couldn’t repeal it when they had the chance. And now even Republican legislatures are acquiescing to the expansion of Medicaid. I think the Democrats got the better end of the deal.