The cynicism of the GOP’s anti-Obamacare strategy has been obvious forever, but some particular kinks in it only became clear as the enrollment deadline approached and it seemed the Obama administration would not just meet but beat its public-exchange enrollment target. Republicans went from shrieking about what an awful program it was to complaining that not enough people had signed up, and then, when the goal was met, complaining that not enough uninsured people had gotten coverage, and of course lying about that, too.
The lunacy of their complaint – “This program is a nightmare – but not enough people are being helped by it!” – is like the old joke about the kvetchy restaurant patron who complains the food is terrible, and the portions are too small. It would be funny if it weren’t sad.
I confess that the freakout over the federal exchange’s rocky start had me convinced the administration would miss its enrollment target. So hitting the seven million mark is cause for elation, but also anger: Imagine how many people might have enrolled if the entire Republican Party coast to coast hadn’t spent the last six months telling them not to?
Let’s take it further: Imagine if all 50 states had implemented their own exchanges, instead of just 17 of them. Imagine if all 50 states had expanded Medicaid, instead of just 27. Imagine if a well-funded noise machine, from Fox to Rush to the online swarm hadn’t publicized every glitch and every allegation of someone losing their insurance, often fabricating the problems, sometimes lying outright, while ignoring every positive story.
It’s absolutely true that this first enrollment period still leaves most of the uninsured without insurance. Still, at least 9.5 million of the uninsured now have care, thanks to the state and federal exchanges, Medicaid expansion and people buying coverage privately. (On Fox, Charles Krauthammer simply lied when he says it's only 1 million.) It must be noted that states that built their own exchanges and expanded Medicaid did much better when it comes to covering the uninsured. The Los Angeles Times estimates that at least 27 percent of the newly insured were previously uninsured; in Kentucky, it's 75 percent and in New York it’s 70 percent. If Republican governors and legislatures hadn’t sabotaged the program in roughly half the states, we would see numbers like that nationwide.
When you add in young people covered by their parents’ insurance and people with pre-existing conditions who can now get coverage, the number goes higher still. As President Obama noted in his Rose Garden victory lap, 100 million people have received free preventive care under new regulations for insurance plans. It’s no wonder that the latest Washington Post/ABC News poll showed approval of the Affordable Care Act topping disapproval for the first time ever, with approval jumping from 40 percent in November to 49 percent last week. Barring a major meltdown, those numbers are likely to climb too.
This is, of course, what the GOP feared – not that the plan would fail, but that it would work. Again, it’s not perfect – we still don’t know exactly who signed up, and whether the balance of young and old, sick and well will make plans affordable. But this enormous milestone should make Democrats smarter about how to make Republicans pay for their obstruction in 2014. The conventional wisdom is that Obamacare will be a millstone in the midterms, especially for red state Democrats, but conventional wisdom is often wrong.
Democrats should challenge Republicans to take away that free preventive care from 100 million Americans. Challenge them to transfer money from women back to men, by letting insurance companies once again charge women more, sometimes much more, for health insurance. Take insurance away from people with pre-existing conditions; kick young people off their parents' plans. Roll back Medicaid expansion in the 27 states that participated. Go on and tell the American people you're going to do that, Republicans. The midterms might not be the cakewalk you think.