Many people think of the right's Obamacare hatred as an outgrowth of straightforward partisan and ideological truths. Movement conservatives broadly oppose the idea of taxing wealthy people to subsidize the lower and middle classes. They don't like regulating the private sector very much either. Add in the political incentives they faced to uniformly oppose President Obama's agenda, the zero Republican votes for the Affordable Care Act, and you've planted seeds of lasting hostility.
But the hostility has become so deeply rooted that it now stands on its own, detached from the ideological and partisan antipathies that gave rise to it.
It has forced conservatives to blind themselves to the law's positive, unobjectionable qualities, and police those within their ranks who dare to acknowledge them.
Talking Points Memo's Josh Marshall called this reactionary phenomenon Obamacare McCarthyism. It ensnared Rep. Jack Kingston, R-Ga., who's running for Senate in 2014 and had the temerity to suggest that Republicans shouldn't just idly mock the law when it stumbles. A few years ago, Sen. Mike Enzi, R-Wy0., said he liked the concept of insurance exchanges -- which are crucial components of GOP-backed Medicare privatization proposals and other conservative reform ideas -- and now a hardline super PAC is using his words against him, as if he'd called for the creation of a public option.
But on the battlefields of partisan warfare, this sort of post-principled contempt, combined with the inception of benefits, has turned the fight over Obamacare from a dispute over first principles, into a culture war, in which signaling matters more than tactical victories.
The repeal campaign -- once marked by earnest and sustained efforts to wipe the law off the books -- has all but burned itself out. But the law remains a potent political organizing force -- a rallying cry Republicans believe they can use to channel the right's Obamacare obsession into voter turnout.
An astute friend remarked to me on Tuesday that the GOP's position on Obamacare is coming to resemble its position on abortion in one key way: loudly, consistently, uniformly opposed, but ultimately not really driven to eliminate it. The backlash they'd face would be brutal, but they might stand to gain by fighting it on the margins and keeping the issue alive.
The comparison holds at a state level too. The most effective Obamacare saboteurs have been GOP governors and legislatures who resisted the opportunity to create their own exchanges and have refused to expand Medicaid with federal dollars, as the law allows.
More generally, conservatives are wielding Obamacare the way they wielded culture war issues in the 1990s. The particulars are enormously different, but the political objectives are similar: pick an issue that both unites conservative voters and appeals to the discontent of moderates and use it first and foremost to fracture the Democratic coalition.
I don't think they're going to fracture the Democratic coalition. But I can imagine the issue remaining an effective mobilizing tool for an otherwise agenda-less party through the end of Obama's presidency.
Of course, the culture wars of the '90s didn't all unfold the same way. Abortion and gun rights have proven to be more durable polarizing tools than immigration and gay rights.
My suspicion is that over time, as Affordable Care Act beneficiaries become friends, neighbors and family members of the law's most ardent foes, hostilities will wane. The word "Obamacare" will have much less unifying power on the right when the law has 30 million beneficiaries than it does with 1 million; and liberals will protect it from broader attacks on social insurance programs with relish, just as they use conservative Medicare and Social Security privatization proposals to their political benefit.
But the bitterness won't just disappear. We're a long way from Southern governors clamoring for the Medicaid expansion, or building their own exchanges, let alone directing their own constituents to enroll on Healthcare.gov. And that's a huge bummer for uninsured people in those states who hoped Obamacare would work as well for them as it's likely to work in the rest of the country.