Obamacare’s Moment of Truth

Published September 23, 2013

For much of the past four years, Americans who believe in freedom have fought tooth and nail against first the passage, and then the implementation, of President Barack Obama’s health care law. This fall, as many of the most significant aspects of the law are finally pushed into action, supporters of the measure still express befuddlement at its unpopularity, which has remained stubborn since its passage.

Frustrated supporters of the law cannot fathom why it has remained so unpopular. Why has the opposition to the law proved so enduring? Why have the American people rejected a measure which was supposed to cover so many people? Why do they view this overhaul of the nation’s health insurance system as a train wreck, even as many acknowledge the old system wasn’t working well to begin with?

There are numerous answers to these questions, but they are answers the law’s supporters do not want to hear. Instead, the “answers” I have personally encountered on the radio and television and even in person are usually just insults regarding the motivations or intelligence of those who oppose Obamacare. “People are too stupid to know what’s good for them,” one Colorado health official told me recently. “It’s because of the well-funded opposition ads,” a radio caller said, perhaps forgetting the millions in taxpayer and campaign funds that have been spent to promote the law. Another caller from Chicago recently told me, “It’s just because Obama’s a black president.”

These accusations of stupidity, partisanship, and racism represent a real problem that the supporters of the law are largely unwilling to address. It is the central point I have made in my writings on Obamacare over the past several years, and it is one I will continue to make as it is implemented. It is simple, it is true, and it is obvious: all that is necessary for Obamacare to become popular is for it to work.

Why Obamacare Doesn’t Work

It’s important to define success: What does it mean for Obamacare to work? It means that the law matches up with the expectations President Obama set in arguing vehemently for it—indeed, in taking the argument to such extremes that he, Senate Majority Leader Harry Reid, and then-House Speaker Nancy Pelosi embarked on a mono-partisan mission to force its passage.

That argument was based on a promise of increased coverage, but that was not its primary selling point. Rather than make the case for Obamacare on moral grounds of universal coverage, Obama tailored his message to what the polls dictated at the time: that the American people who are insured generally like their insurance, their plan, and their doctor; they just wish it would cost less.

Knowing that’s what Americans wanted to hear, that’s what Obama promised his law would do. After all, he had never been a leading voice on health care policy to that point, nor had he ever claimed he was an expert on the issue. In fact, during his run for the presidency, Obama campaign aides Robert Gibbs and Jon Favreau had come up with the idea to promise he would pass universal coverage by the end of his first term, when they needed a big idea for a speaking engagement at the liberal Families USA conference.

“We needed something to say,” one of the advisers involved in the 2007 discussion recently told Politico. “I can’t tell you how little thought was given to that thought other than it sounded good. So they just kind of hatched it on their own. It just happened. It wasn’t like a deep strategic conversation.”

Leaderless Legislation

Having put so little thought into what his health care reform would involve, it’s little wonder Obama put so little effort into actually crafting the legislation. Instead, it was crafted in back rooms by high-level congressional staff and industry representatives, chock full of the worst kinds of cronyism Washington has ever seen. It was designed to turn the insurance industry into a publicly regulated utility, with their compliance bought by making it illegal not to purchase their product.

The host of mandates, regulations, and redistributive subsidies did little to hide a few basic facts: the law fundamentally transformed the relationship of the citizen and the state; the expansion of coverage was overwhelmingly based on expansion of Medicaid, the nation’s worst-functioning health care program; and the $2,500 reductions in premium costs—promised so frequently by Obama—were never going to materialize.

This, now, is Obamacare’s moment of truth: the moment when the American people will see whether the promises match up with the rhetoric. If they do, Obamacare will be a political success, and an unmitigated one. But if they don’t, the political consequences could alter the nation’s future.

One final note: It has been my pleasure to research and write on Obamacare and other health care issues over the past several years as managing editor of Health Care News. I am now embarking on a new venture as publisher of The Federalist, a new web magazine on politics, policy, and culture. I will retain my affiliation as a Senior Fellow with The Heartland Institute, and will continue to write on health care and entitlement policy. This is a critical time in our nation’s history, and I wouldn’t miss this moment of truth for anything.

Benjamin Domenech ([email protected]) is a senior fellow at the Heartland Institute.