When Republicans in Congress go on their annual retreat next month to strategize for 2014 – a midterm election year when a GOP Senate takeover dangles tantalizingly – this much is certain: Their plan will include a continued focus on the troubles of the Affordable Care Act.
As House Speaker John Boehner (R) of Ohio told reporters in parting remarks before the House broke for Christmas recess, Republicans will continue to “look for ways to protect the American people from Obamacare.”
Politicians on both sides of the aisle sense electoral consequences from problems with the health-care law. Republicans hope it’s the golden goose that keeps on giving them talking points, while Democratic lawmakers fear it will become the albatross that destroys their Senate majority.
The outlook for President Obama’s signature domestic program is far from clear, with Sen. Joe Manchin (D) of West Virginia recently referring to 2014 as a “transitional year.” Many questions remain unanswered: Will there be enough enrollees, especially young people? Will the program bring down health costs? Will the administrative potholes be filled and smoothed? Will people praise or pan their insurance plans?
Key points in the calendar will give clues to the answers. In mid-January, the White House expects to know how many people who needed insurance by Jan. 1 signed up for it (Tuesday, Dec. 24, is the deadline). The enrollment period for everyone else ends March 31. Other developments, such as a new legal challenge, could also affect the law.
With divided government, Republicans haven’t been able to repeal the Affordable Care Act (ACA) – and they disagree on what a replacement should look like. So “protecting the American people” consists of relentless messaging on the defects of "Obamacare" (this past weekend’s radio address was aimed at young people who might enroll, warning them of the Obamacare “rip-off”); collecting and publicizing tragic stories of constituents ill-served by the program; and holding oversight hearings on Capitol Hill and in the field.
Since rollout of HealthCare.gov, the Obamacare signup website, crash landed on Oct. 1, the GOP hearings machine has hummed along in high gear. House committees or subcommittees on oversight, health, small business, education, and ways and means have questioned physicians, people purchasing insurance, and state and federal officials, including Health and Human Services Secretary Kathleen Sebelius and others responsible for the program. On Dec. 4, the Hill was awash in witnesses, with four Obamacare-related hearings on one day.
“The hearings are a legitimate exercise of oversight responsibility. However, there is a strong dose of partisan channeling and showmanship,” says Larry Kocot, a visiting fellow at the Brookings Institution, who helped roll out Medicare Part D, the prescription-drug benefit introduced during the George W. Bush administration.
Democrats on the Hill have tried to point out the advantages of the ACA – to women, for instance – but they have not been as consistent or as strong in their messaging as Republicans. As the White House works to fix and adjust everything from the HealthCare.gov website to deadlines for enrollment, Democratic lawmakers find themselves holding a Christmas stocking of coal.
Senator Manchin has gone so far as to introduce legislation that would put off the penalty part of Obamacare until 2015. That would give a year to work out kinks in the law, he explained on CNN on Sunday. But it also undermines the “mandate” aspect of the law, which was designed to build an actuarially sound insurance program by making sure everyone has health insurance – or pays a fine. Many Republican lawmakers have also sought delays in the program, and Manchin’s bill is cosponsored by Sen. Mark Kirk (R) of Illinois.
“At least now there’s recognition on the part of proponents of the law that there are changes that will need to be made,” says G. William Hoagland, a senior vice president at the Bipartisan Policy Center think tank. “Whether those can be accepted by opponents of the law or if they still want to kill the law – that’s open for the debate.”
At this point, given the rough Obamacare rollout so far, Republicans seem loath to sacrifice their golden goose.