The president’s signature legislative achievement, the Affordable Care Act, is in serious trouble. As a result, so is modern liberalism. The problems with Obamacare are increasingly obvious, beginning with the administration unilaterally delaying the employer mandate. But that turned out to be merely one link in a long and troublesome chain.
The other difficulties include the disastrous rollout of the federal health care exchange website, causing (for now) a six-week extension for Americans to sign up for coverage next year in order to avoid new tax penalties. There are millions of insurance cancellations. Then there’s the sticker shock caused by higher premiums and deductibles and the danger of what insurers call a “death spiral,” in which not enough young and healthy people sign up in the exchanges, leading to rising prices, further declines in enrollment, and a destabilized market.
Not to be overlooked is the mountain of broken Obama promises, including the president’s repeated assurances, which we now know to be false, that you can keep your health plan if you like it. Restive Democrats are now calling for a delay in the individual mandate, and Obamacare is being mocked on such reliably liberal shows as Saturday Night Live and The Daily Show with Jon Stewart. All for a program that will, at best, still leave 30 million people uninsured, according to the Congressional Budget Office.
Now if you believe, as we do, that Obamacare was incoherently designed and suffers from massive structural flaws, there’s no reason to think things are about to get better. Quite the opposite. The warnings issued by conservatives during the health care debate are in the process of being vindicated. And the president looks increasingly helpless to fix what’s amiss.
As for those who believe that once the exchanges and subsidies kick in, “it’s going to prove almost impossible to undo Obamacare” because people will react like sugar addicts, it’s important to realize that the entitlement portion of the Affordable Care Act will be enjoyed by only a small slice of Americans. For most, choice and access will be restricted and prices will go up. The downside of Obamacare will end up affecting many more Americans than the upside. That’s because the Affordable Care Act isn’t a program that just gives people money; it’s one that tries to manage the health insurance sector and looks likely to manage it in a very unpopular way.
The political ramifications could be enormous. Precisely because the Affordable Care Act is the realization of a half-century long liberal dream, if it fails, it will be a crushing blow not just to Barack Obama but to American liberalism itself. Why? Because Obamacare is in many ways the avatar, the archetype, of modern liberalism. That’s true in terms of its coercive elements, its soaring confidence in technocratic solutions, its ambition to centralize decisionmaking, and its belief that government knows best. You may like your health care plan, but the role of the benevolent nanny state is to impose its will on you. And we see the zealous aspirations of liberalism in using a discrete problem, in this case the uninsured, to remake our entire health care system.
Critics of the president may be wrong. Obamacare may turn out to be one of the most successful and popular programs in the history of man. But whether they are right or wrong, there is at least no confusion as to who has ownership of the Affordable Care Act. We all know who stood where, when; who supported it and who opposed it; and we are now in the process of being able to judge the claims of Obamacare against the reality of Obamacare. An abstract debate can now be measured by its true effects on the nation as a whole.
It looks to us that liberalism, in getting what it wanted, will end up doing significant and sustained damage to itself, to public confidence in government (which is already near historic lows), and to its conception of the welfare state.
It would be quite an historical irony if Obama, who raised such extravagant hopes among progressives when he ran for office, turns out to have a shattering effect on contemporary liberalism. But that may be just where we are heading. Barack Obama may turn out to be the best thing to happen to conservatism since Ronald Reagan.