Riding a late tidal wave of interest, President Obama's health care law has overcome its early botched rollout to sign up more than 7 million Americans, the White House announced on Tuesday.
As I’ve noted in the past, there are a number of questions surrounding the headline numbers touted by the administration. The main number doesn’t say how many of those who have signed up for coverage will officially enroll by paying their premiums, how many were previously uninsured, how many are young and healthy, or how individual states are doing.
But whatever the final number, there now appear to be enough Americans benefiting from Obamacare to make it much more difficult -- if not impossible -- for Republicans to ever fully repeal the law. Even more so when one includes the millions covered through the Medicaid expansion.
When Obama made his now-infamous promise that if people liked their health care plans they could keep them, he did so because he understood that any significant changes to the health care system would cause disruptions, so he needed to reassure Americans that their plans wouldn’t be affected by what he was proposing. It was a clear lie, but one that was rooted in an understanding of political realities.
If Republicans had taken over the White House last year and pursued the repeal of Obamacare, they could have done so at a time when the law’s beneficiaries were mostly theoretical. Now, however, Republicans will be facing the same problem Obama did. Only more so, because they've invested so much in the idea that nobody can lose coverage as a result of health care legislative changes.
Even if the law remains broadly unpopular, Republicans will have have to deal with the fact that millions of Americans would have their coverage disrupted by repeal. And everybody knows how well it worked out for Obama when, at the height of last fall’s backlash against plan cancellations, he tried to downplay the millions of people being affected as only a small percentage of the population.
To be sure, the raw signup numbers don’t say anything about other potential problems posed by Obamacare — the threat of future premium spikes, doctor shortages, reduced innovation, cost overruns, payment reforms to Medicare that don’t spur the desired efficiencies, and so on.
So, it isn’t as if there won’t be any openings for Republicans to push reforms to the health care system that attempt to inject more freedom and choice into the system. It just means that any policies being advanced by the GOP will have to grapple with what to do with the millions of Americans gaining coverage through Obamacare.