The roll-out of the Affordable Care Act has hatched a spasm of obituaries for Obama's second term, and more than a few for Liberalism as We Know It. That's right, Error 404: Ideology Not Found.
At best, pundits have surmised that Obama's popularity will never recover. Comparisons between the implementation of insurance exchanges and the Iraq War or Katrina, as infuriating as they are (how many times do we have to say it: Bush lied, people died; website crashed, people complained on Twitter) do suggest that a mid-term catastrophic failure can derail an entire presidential agenda.
Charlie Cook, writing in The National Journal, had the most concise rebuttal of this theory: it's way too early to tell. Or, put as a critique of the logic behind the death notices: pundits tend to think that any given political situation is static, but the truth is that a variety of circumstances can change either voters' perspective or the real impact of presidential actions. Here's a few things that could lift Obama out of his slump.
1. Wait until you see the other guy
Obama benefits when he can function in full campaign mode and present an "apples to apples" comparison to voters. When the GOP primary ramps up, he'll get a chance to do this again. His last sustained high in approval came in November 2012; that 56% high-water mark was in the week after the Newtown shootings and many attributed it to a "rally around the flag" surge in patriotism, but the week previous – in the direct aftermath of the elections – it had been at 54%. In fact, Obama sporadic surges throughout 2012 all came after voters were given a chance to think about another specific politician doing the same specific job, most notably after the Democratic and Republican conventions in late summer.
The White House's attempts to push non-ACA stories is clearly an attempt to take advantage of this strength. Whereas the ACA has made it possible for the GOP to simply point at the mess and not necessarily offer solutions, when it comes to immigration reform or foreign policy, Obama has a chance to define himself against an existing set of competing ideas. Think of that situation as judging two applicants for a position: Obama interviews better. Contrast this to what happens when, say, you have two teams on a field playing a penalty-ridden scoreless game (such as during the budget negotiations): spectators are disgusted by both sides. (Some strategists in the GOP seem to believe that such chaos has at least short-term benefits for their side, hence their glee in perpetuating it.)
2. The Republican Party is fighting itself
The GOP's fraught internal battles have fractured it severely, perhaps irreparably (considering that many are asserting the demise of liberalism, I should probably make clear here that I'm sure conservatism will do just fine). While most commentators, including myself, have adopted the shorthand of "The Tea Party versus the establishment", the schisms range across ideological, attitudinal, generational and even regional lines. There is no reason to believe that that the debates will stay civil; indeed, they've already gotten pretty ugly. Some fist fights have broken through at the national level (Rand Paul versus Chris Christie, Ted Cruz versus John McCain, Boehner versus his caucus). Those simmering at the state level threaten party unity just as much, especially the plit in Iowa GOP between a libertarian faction that gained control in 2012 and a legacy cohort that wants to regain the advantage and steer the First-in-the-Nation Caucus to anyone not named Rand Paul. Imagine a primary battle that starts with a drawn-out slugfest among Cruz, Rand and Christie.
In Ohio, Governor John Kaisch, once lauded as a lauded 2016 GOP presidential contender, now faces a barrage of criticism for his embrace of the ACA's Medicaid expansion. As long as the ACA stays symbol of all that's wrong with "big government", the message is damaging. But it could backfire if Kaisch gains re-election (as it looks like he will) using a defense of the Medicaid changes that, with the exception of a single word, could just as easily come from Elizabeth Warren as a Republican: "I think its critical that we're able to help people to help themselves to get them to work. … Conservatism means that you help people so they can help themselves and so they can enter in the economic strength of our country."
3. The success stories from the ACA will come out
The dysfunctional exchange websites have meant that ACA "success stories"– struggling families gaining health insurance they once could not afford – are all but buried, while conservatives push into that void the "horror stories" of relatively affluent self-insured households (on Fox at least, many of the featured case-studies seem to have existing ideological objections to the ACA). As the roll-out has continued, however, the trickle of stories about working-class families breathing easier (and thus contributing to a more robust economy) thanks to the ACA exchanges has gained strength. The numbers will eventual outweigh the anecdotes: Republicans have counted about about one million Californians as among those to whom Obama broke his "if you like it, you can keep it" promise. But it's estimated that about two million residents, including almost all of the holders of those cancelled policies, will receive subsidies to purchase insurance plans that pass the ACA minimum requirements (aka, better plans) that are also ultimately cheaper – even if the premiums are higher, their out-of-pocket expenses will go down thanks to fully covered preventive care, lower deductibles and no penalties for previously existing conditions.
The California numbers reflect analysis that takes into consideration not just cancelled policies but all those who might benefit from subsidies, but even if one sticks to the outcomes for those with cancelled plans, the picture is far from bleak – in North Carolina, 60% of those with cancelled policies will qualify for subsidies; in Florida, 66 percent; in Utah, 84% do. Between five and six million people who do not qualify for the Medicaid expansion and are currently uninsured – arguably the precise demographic for whom the ACA was created – will get subsidies that cancel out entirely the cost of the cheapest policies available, at least one million more Americans than have had their existing policies cancelled. The individual stories of these policy holders exist with or without a functioning federal website, and some reporters have found them, so they will just take longer to get out. But they will get out.
This article originally appeared on guardian.co.uk
