Obamacare and the American People

[Frodo]

When will a sustained majority of Americans approve of the Affordable Care Act as a whole, and make it their own the way they have done with Medicare and Social Security?  Do we have to wait until Barack Obama leaves the White House, with Hillary Clinton taking over?  At what point will it be accepted? 

[Wells]

It'll just become a fact of life.
Since it's commonly referred to as Obamacare, it will probably also be known as Obama's greatest accomplishment in 50 years, next to his fixing of the economic crisis.

[Mr. Reactionary]

When those with insurance before Obamacare forget how high the law pushed up premiums for most of us.

[Young Conservative]

Never.

[DavidB.]

Do you have a source that proves this isn't the case?

[Ebsy]

It already is. When it comes down to it, the next Republican president won't be able terminate the health insurance of millions of people.

[Attorney General, LGC Speaker, and Former PPT Dwarven Dragon]

It already is. When it comes down to it, the next Republican president won't be able terminate the health insurance of millions of people.

Let's go through the plausible reasons for it being impossible:

1. Congress - Well, if the republicans win the white house, odds are they come in with control of the house and the senate. This is true whether they win now or in 2020 or whatever.

Democrats have yet to gain the sort of control over governor's mansions and state legislatures that they'd need to de-gerrymander the house, and with Hillary as president, they aren't getting the gains they need in 2018, and will lose several senate seats. Even with a republican president, 2018 isn't guaranteed to be a good democratic year due to midterm turnout patterns and a tough senate map. A similar map will be in play for 2024 for what it's worth. All of the gains that republicans got in 2014 will stick around in 2020 if the country is electing a republican, except for MAYBE Ernst in Iowa. Even with a good map for 2016, it is going to be tough for dems to gain five senate seats if the country is electing a republican.

So, should a republican presidency happen in the next few cycles, I have little doubt that it will be with control of both the house and the senate.

2. Well, the house could pass it, but Senate Democrats would have the votes to filibuster it - While this is true in theory, one forgets that the existence of the filibuster is at the whim of the majority party. The democrats took it away while they were in power for all nominations except for those to the Supreme Court (a change republicans have yet to reverse, for what it's worth), the republicans can do the same thing with health care legislation. Not abolishing it for all future health care legislation, lest a future democratic majority instill single payer on the nation, just abolishing it for "all health care legislation that replaces health care legislation passed before 2015" or some language like that. They then can pass their repeal/replace bill for ObamaCare with just 50 votes (The republican VP breaks any 50-50 tie vote in the Senate) in the Senate. Yeah, it's a nuclear option, but there's nothing preventing the republicans from doing this as long as they can get (essentially) all their senators on board with the rule change. Only 51 votes are needed to change senate filibuster rules under the so-called nuclear option. And I do think the republicans are bold enough to do it. They've made ObamaCare repeal a centerpiece of the platform, a litmus test to get into the party in fact, anyone who praises even its most popular parts is criticized until they take back their statements, and support for expanding medicaid and/or setting up a state exchange has to be coded in terms like "helping the poor as god commanded me" or "dealing with an unfriendly legislature" or "ensuring this federal mandate causes the least possible harm", or simply never mentioned outside of private government meetings. ObamaCare is very unpopular among the Tea Party, which despite reports of demise, came fairly close to taking out Pat Roberts and Lamar Alexander with D-Level candidates, and remains something that the republicans ignore at their electoral peril. So the filibuster won't stop ObamaCare Repeal either.

3. Republicans won't be able to bring themselves to do it. They'll talk about it, but never actually pass the bill. Just make excuses for 4 or 8 years. - I think I rebutted this pretty well above.

Now, obviously if a republican doesn't get elected until 2028 or later, then people will have probably forgotten about the issue by then, and it won't be done only due to having "moved on to other issues", not because the party suddenly supports it or something. But if a republican gets elected in 2016, 2020, maybe even 2024, ObamaCare is going down.

[Ebsy]

It already is. When it comes down to it, the next Republican president won't be able terminate the health insurance of millions of people.

Let's go through the plausible reasons for it being impossible:

1. Congress - Well, if the republicans win the white house, odds are they come in with control of the house and the senate. This is true whether they win now or in 2020 or whatever.

Democrats have yet to gain the sort of control over governor's mansions and state legislatures that they'd need to de-gerrymander the house, and with Hillary as president, they aren't getting the gains they need in 2018, and will lose several senate seats. Even with a republican president, 2018 isn't guaranteed to be a good democratic year due to midterm turnout patterns and a tough senate map. A similar map will be in play for 2024 for what it's worth. All of the gains that republicans got in 2014 will stick around in 2020 if the country is electing a republican, except for MAYBE Ernst in Iowa. Even with a good map for 2016, it is going to be tough for dems to gain five senate seats if the country is electing a republican.

So, should a republican presidency happen in the next few cycles, I have little doubt that it will be with control of both the house and the senate.

2. Well, the house could pass it, but Senate Democrats would have the votes to filibuster it - While this is true in theory, one forgets that the existence of the filibuster is at the whim of the majority party. The democrats took it away while they were in power for all nominations except for those to the Supreme Court (a change republicans have yet to reverse, for what it's worth), the republicans can do the same thing with health care legislation. Not abolishing it for all future health care legislation, lest a future democratic majority instill single payer on the nation, just abolishing it for "all health care legislation that replaces health care legislation passed before 2015" or some language like that. They then can pass their repeal/replace bill for ObamaCare with just 50 votes (The republican VP breaks any 50-50 tie vote in the Senate) in the Senate. Yeah, it's a nuclear option, but there's nothing preventing the republicans from doing this as long as they can get (essentially) all their senators on board with the rule change. Only 51 votes are needed to change senate filibuster rules under the so-called nuclear option. And I do think the republicans are bold enough to do it. They've made ObamaCare repeal a centerpiece of the platform, a litmus test to get into the party in fact, anyone who praises even its most popular parts is criticized until they take back their statements, and support for expanding medicaid and/or setting up a state exchange has to be coded in terms like "helping the poor as god commanded me" or "dealing with an unfriendly legislature" or "ensuring this federal mandate causes the least possible harm", or simply never mentioned outside of private government meetings. ObamaCare is very unpopular among the Tea Party, which despite reports of demise, came fairly close to taking out Pat Roberts and Lamar Alexander with D-Level candidates, and remains something that the republicans ignore at their electoral peril. So the filibuster won't stop ObamaCare Repeal either.

3. Republicans won't be able to bring themselves to do it. They'll talk about it, but never actually pass the bill. Just make excuses for 4 or 8 years. - I think I rebutted this pretty well above.

Now, obviously if a republican doesn't get elected until 2028 or later, then people will have probably forgotten about the issue by then, and it won't be done only due to having "moved on to other issues", not because the party suddenly supports it or something. But if a republican gets elected in 2016, 2020, maybe even 2024, ObamaCare is going down.

I'm pretty confident that the ACA will not repealed unless it is replaced with a nearly identical program. Republican hatred of the ACA is no more vehement then their hatred of Social Security, Medicare, Medicaid, etc, all entitlement programs that still stand today despite large Republican opposition at their outset. My bet is that once a Republican is a elected to the presidency(2020 or 2024), Obamacare Repeal will either have been abandoned or it will get quickly buried by some other more pressing domestic policy goal. At the end of the day, the first act of a new Republican administration won't be to collapse the private health insurance market, which is what would happen if ACA subsidies suddenly dried up.

[Mr. Reactionary]

Republican hatred of the ACA is no more vehement then their hatred of Social Security

You serious?

[Virginiá]

I'm pretty confident that the ACA will not repealed unless it is replaced with a nearly identical program.

They would have to, though, I'm sure they could be stupid enough to just repeal and leave it at that. PPACA has already settled in. If they rip it out, there will be a backlash. Aside from the millions who would end up losing insurance, the reinstatement of preexisting condition limitations and people under 26 being removed from family plans would be deeply unpopular once the reality of its loss sets in.

The best time to repeal it was years ago, and we all know that simply was not possible.

[Ebsy]

Republican hatred of the ACA is no more vehement then their hatred of Social Security

You serious?

Totally. After social security was passed, don't you think Republicans were angry and thought they would repeal it the next time they took the White House?

[RI]

Republican hatred of the ACA is no more vehement then their hatred of Social Security

You serious?

Totally. After social security was passed, don't you think Republicans were angry and thought they would repeal it the next time they took the White House?

Democrats held the White House for 18 years after SS passed. There's virtually no way the Dems hold the White House through 2028, however.

That said, unless the GOP wins the Presidency in either 2016 or 2020 with Congress behind them, the ACA's probably locked in for the foreseeable future.