This March will mark three years since Obamacare became law, and it still has not had any serious effect on most Americans’ lives. That’s the way President Obama and the law’s Democratic authors planned it; they conveniently pushed the dislocations and unhappy consequences of national health care well past their re-election campaigns.
But Obamacare will be here soon, with an Oct. 1, 2013, start of enrollment in insurance exchanges and a Jan. 1, 2014, deadline for full implementation. The political results could be deeply painful for Democrats.
During the campaign for Obamacare, President Obama pledged repeatedly that his health care scheme would not touch the vast majority of Americans who are satisfied with their coverage. “No matter how we reform health care, we will keep this promise to the American people,” Obama said in June 2009. “If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.”
If anyone believed that then, they probably don’t believe it now. In practice, Obamacare will mean the loss of employer-based health insurance for many people; big increases in premiums for others; changes on the job for still others; and a bureaucratic nightmare for many more. Add to that the involvement of the Internal Revenue Service, which will act as Obamacare’s enforcer — all Americans will have to prove to the IRS that they have “qualified” coverage — and it’s likely Obamacare will have a rocky and unpopular start.
Over the past months there has been scattered press coverage of coming problems. That is likely to increase in 2013. There will be more stories with headlines like this, from Bloomberg News recently: “Aetna CEO Sees Obama Health Law Doubling Some Premiums.”
And this, from the Associated Press: “Surprise: New Insurance Fee in Health Overhaul Law.”
And this, from the Wall Street Journal: “Health-Care Law Spurs a Shift to Part-Time Workers.”
Real-world experience might even spark some rethinking of Obamacare’s premises. For example, the president and his Democratic allies promised Obamacare will cut the deficit. That’s almost certainly not true, although many in the press repeated it faithfully. Now, with Obamacare near, there are hints of a reassessment.
For example, in a recent editorial about fiscal cliff negotiations, The Washington Post noted that the nation’s “underlying fiscal problem is that federal expenditures are slated to rise faster than economic growth,” and that “the long-term drivers” of those federal expenditures are “Medicare, Medicaid, Social Security and subsidies for the health-care exchanges established by the Affordable Care Act.” Obamacare will take its place as a contributor to future deficits.
Obamacare has never been popular. Indeed, it has been underwater in terms of public approval from the moment it began to take legislative shape in 2009. In last month’s exit polls, 49 percent said all or part of Obamacare should be repealed, while 44 percent said it should be left as is or expanded.
“There hasn’t been any trend,” says pollster Scott Rasmussen. “From the beginning, well before the law was passed, public opinion has been remarkably stable and modestly negative. ... All of that has been based upon theory and politics. Most Americans have not yet felt any impact from the law.”
If Obamacare were popular, there’s no doubt more governors would choose to have their states set up insurance exchanges, as the law envisioned. Instead, nearly two dozen Republican governors have refused, which will force the federal government to build the exchanges itself.
The governors are saying no to state-run exchanges for three reasons. One, they believe it will cost their states too much money. Two, they believe the federal government will exercise ultimate control over everything, despite federal reassurances that states will play a significant role. And three, many believe Obamacare implementation will be a disaster.
Some who watch Obamacare closely see something similar. “The administration is well behind schedule,” says James Capretta of the conservative Ethics and Public Policy Center. “It’s going to be a train wreck in a lot of places.”
Capretta sees the administration trying to paper over some of the problems by rushing billions of dollars in subsidies out the door. That way they will argue Obamacare is doing much good, whatever its flaws.
But it’s possible no amount of money will be enough to hide those flaws — once Obamacare becomes a reality in Americans’ lives.
Byron York is chief political correspondent for The Washington Examiner.