Why Obamacare Is On Life Support

Democrats may begin calling for repeal if the law’s problems don’t get resolved soon.

National Journal
Josh Kraushaar
Nov. 18, 2013, 12:10 a.m.

There’s noth­ing that Demo­crats want more than to change the sub­ject from Obama­care, des­pite DNC Chair­man Debbie Wasser­man Schultz’s prot­est­a­tions oth­er­wise. Con­gres­sion­al Demo­crats don’t want to be deal­ing with a drip-drip of news about premi­ums go­ing up, pa­tients los­ing their doc­tors, and a broken health care web­site as they face angry voters in 2014. Hil­lary Clin­ton doesn’t want this is­sue linger­ing past the midterms. She hitched her pres­id­en­tial pro­spects to Pres­id­ent Obama’s wag­on and she’s not about to let someone else’s crisis dam­age her pres­id­en­tial am­bi­tions yet again, Even Vice Pres­id­ent Joe Biden, who called the health care law a “big f—-ing deal,” didn’t men­tion it once at a fun­draiser last week for North Car­o­lina Sen. Kay Hagan.

Un­less the Health­Care.gov web­site mi­ra­cu­lously gets fixed by next month, there’s a grow­ing like­li­hood that over time, enough Demo­crats may join Re­pub­lic­ans to de­cide to start over and scrap the whole com­plex health care en­ter­prise. That be­came clear when even Obama, to stop the polit­ic­al bleed­ing, offered an ad­min­is­trat­ive fix that threatened the vi­ab­il­ity of the en­tire in­di­vidu­al ex­change mar­ket to fore­stall a House Demo­crat­ic mutiny the next day. It was as clear sign as any that the pres­id­ent is pess­im­ist­ic about the odds that the fed­er­al ex­change web­site will be ready by the end of the month, as prom­ised.

More than any­thing, polit­ics is about self-pre­ser­va­tion, and the last two weeks provided nu­mer­ous ex­amples of how pub­lic opin­ion has turned so hard against the law that even its most ar­dent sup­port­ers are run­ning for the hills. It’s not just red-state Demo­crats, like Louisi­ana Sen. Mary Landrieu, dis­tan­cing them­selves from the law. It’s blue-state sen­at­ors like Ore­gon’s Jeff Merkley and New Hamp­shire’s Jeanne Shaheen — and top blue-state re­cruits like Michigan’s Gary Peters and Iowa’s Bruce Bra­ley, who voted for GOP le­gis­la­tion Fri­day that the White House said would “gut” the law. Nearly every House Demo­crat in a com­pet­it­ive dis­trict joined with Re­pub­lic­ans to threaten the law. Without a quick fix, those ranks will grow.

This tsunami of blow­back, which built in just the last month, is un­sus­tain­able for Demo­crats over the long haul. The pres­id­ent isn’t just los­ing his skep­tics from the chaot­ic Obama­care rol­lout but his al­lies who stood to gain from the law’s be­ne­fits — namely His­pan­ics, whose ap­prov­al of the pres­id­ent has dropped more than any demo­graph­ic sub­group since the prob­lems began. The simplest solu­tion — if only to stop the bleed­ing — is to get the web­site fixed. (When former DNC Chair­man Howard Dean’s pro­pos­al is to hire tens of thou­sands of young phone op­er­at­ors to sign people up for in­sur­ance — straight out of a Jerry Lewis telethon — as he sug­ges­ted on “Morn­ing Joe,” it’s clear the web­site prob­lems are really bad.).

Would Pres­id­ent Obama sign a death war­rant on his own sig­na­ture le­gis­la­tion? That’s al­most im­possible to ima­gine, but it’s en­tirely reas­on­able that he may not have a choice in the mat­ter. Con­sider: Des­pite the White House’s prot­est­a­tions, 62.4 per­cent of the House voted for Michigan GOP Rep. Fred Up­ton’s le­gis­la­tion (261-157), just shy of the two-thirds ne­ces­sary to over­ride a veto. And con­sider the House Demo­crats who voted against Up­ton’s bill but non­ethe­less re­leased harsh state­ments cri­ti­ciz­ing Obama­care. Mary­land Rep. John Delaney, in a state­ment, wrote: “The prob­lem we have cur­rently is that the Af­ford­able Care Act is not work­ing.” Ad­ded Ari­zona Rep. Ann Kirk­patrick: “The stun­ning in­eptitude of the ACA mar­ket­place rol­lout is more than a pub­lic re­la­tions dis­aster. It is a dis­aster for the work­ing fam­il­ies in my Ari­zona dis­trict who badly need qual­ity, af­ford­able health care.” Add them in­to the mix — the dozens more mem­bers who were poised to split with the pres­id­ent un­til his face-sav­ing press con­fer­ence — and you’ve got all but the hardy Obama loy­al­ists who could end up bolt­ing if the polit­ic­al en­vir­on­ment doesn’t im­prove.

Demo­crats are in bet­ter shape on the Sen­ate side, but not by as much as con­ven­tion­al wis­dom sug­gests. Sen­ate Ma­jor­ity Lead­er Harry Re­id will do everything in his in­flu­ence to pro­tect the pres­id­ent — and block em­bar­rass­ing le­gis­la­tion from be­ing voted on — but not if it means he’ll be los­ing his ma­jor­ity gavel next year. There are 21 Demo­crat­ic held-seats up in 2014, with 17 Demo­crat­ic sen­at­ors run­ning for re-elec­tion. Of those 17, 10 are run­ning in states where Obama won less than 55 per­cent of the vote, ap­prox­im­ately the baseline of where House Demo­crats began split­ting with the pres­id­ent on the Up­ton vote. Ex­clud­ing Re­id, an ad­di­tion­al 15 Demo­crats aren’t up in 2014, but rep­res­ent battle­ground (< 55% Obama) states where sup­port of the law could be­come a long-term bur­den. And then there’s Cali­for­nia Sen. Di­anne Fein­stein, who has emerged as a sur­pris­ing blue-state crit­ic of the law, re­tir­ing Montana Sen. Max Baucus, who fam­ously pre­dicted the im­ple­ment­a­tion was shap­ing up to be a “train wreck,” and re­tir­ing mod­er­ate South Dakota Sen. Tim John­son.

To over­come a veto, Re­pub­lic­ans would need 22 of those 28 win­nable votes. Right now, they wouldn’t come close. But Re­id and the White House may end up re­ly­ing on swing-state Demo­crats like Claire Mc­Caskill and Bob Ca­sey to pro­tect the law. If the polit­ic­al mood doesn’t im­prove in short or­der, will they want to be in that po­s­i­tion? And if Re­pub­lic­ans re­take the Sen­ate in 2015, the polit­ic­al mo­mentum for re­peal would only grow.

Even in the face of rough pub­lic opin­ion, the man­tra of Con­gres­sion­al Demo­crats has been to fix the health care law, not cater to Re­pub­lic­an ex­trem­ism to re­peal it. But after the pres­id­ent’s press con­fer­ence last week, there’s been a palp­able pess­im­ism in Demo­crat­ic strategists’ think­ing. When I asked one Demo­crat­ic cam­paign op­er­at­ive why blue-state Sen­ate can­did­ates like Peters and Bra­ley would sup­port a bill that the White House said would gut Obama­care, the an­swer was: “We’re on our own. We don’t care what the White House says. Would you trust them?”

That’s the type of think­ing that could en­danger a health care law that seemed un­touch­able sev­er­al months ago. If the ad­min­is­tra­tion can’t fix the myri­ad prob­lems ail­ing the health care ex­change web­site, and more sob stor­ies emerge about people los­ing or pay­ing sig­ni­fic­antly more for their in­sur­ance, it’s an un­sus­tain­able for­mula for Demo­crats. There’s not much time left on the elec­tion clock to turn things around. They’ve shown un­fail­ing loy­alty to the pres­id­ent, but un­less he man­ages an un­likely fourth quarter comeback, those bonds could break — and the res­ults could get ugly.