Healthcare repeal is no lost cause

By Christopher Caldwell

When President Barack Obama sought to stiffen the resolve of Democratic congressmen on the day before they enacted his plan for near-universal healthcare, he took a moment to mock the commentator Karl Rove and other Republicans, who were warning wavering Democrats that a Yes vote would cost them their seats. “It could be that they are suddenly having a change of heart and they are deeply concerned about their Democratic friends,” Mr Obama said wryly. “That’s a possibility.”

We should greet with a similar scepticism the warnings of Mr Obama’s own supporters. They say Republicans will suffer if, as promised, they fight next November’s elections on an agenda of repealing the reform just passed. Momentum is gathering for such a repeal effort. Senate minority leader Mitch McConnell said this weekend: “Americans opposed this legislation, and now they’re clamouring to see it repealed and replaced.” Writing in The Week, Robert Shrum, the Democratic consultant, took a different view. “If the GOP actually keeps its pledge to campaign on repealing the law,” he wrote, “it will only accelerate its marginalisation.”

Mr McConnell is, in essence, right. While the “clamouring” is not unanimous, no landmark new law has been so unpopular in modern times. The most recent poll, by The Washington Post, shows 50 per cent of the country opposed and 46 per cent in favour. Moreover, 43 per cent “strongly disapprove” of Mr Obama’s handling of healthcare.

Both parties believe the Democrats will lose a lot of seats in both houses this autumn. Democrats claim to relish an argument about repeal because they think people will grow more attached to the law the more they learn about it. That is not certain. The public already know the legislation well (if your basis of comparison is their knowledge of other legislation, and not omniscience). Disdain has been robust and consistent. Support has not risen much above 40 per cent since last July. The debate followed the same pattern as when President Bill Clinton tried to establish universal coverage: the satisfaction of insured Americans (the vast majority) with their healthcare is astronomically high. The public support making cover universal until they discover that doing so probably means curtailing the healthcare of the insured. Then they fight it tooth and nail.

Rising support for the new law is certainly possible. Americans, like most publics, have a bias in favour of settled institutions. But it is possible that support will fall, too. The law rests on the kind of actuarial sleight of hand that, in the private sector, has repelled voters ever since the Enron scandal. We are now in a climate of waxing anxiety over deficits and waning trust that the government has a strategy to exit from its stimulus spending. This week’s stunning report from the Congressional Budget Office that the Social Security Administration has gone into the red six years ahead of schedule will damp enthusiasm for big new social legislation.

Republicans enter the fray at a disadvantage. They have a track record of inaction on those healthcare problems (such as cost and portability of coverage) that trouble the whole electorate. The public, the Post poll finds, still trust the Democrats more on such things. But the damage to Mr Obama’s position from the healthcare battle could be permanent. His election in 2008 rested on independents drawn to his rallying cry about how “there is not a red [Republican] America and a blue [Democratic] America, there is a United States of America”.

Mr Obama’s behaviour during the healthcare debate suggests he no longer believes this, if ever he did, and he is paying dearly for the deception. In by-elections in Virginia, New Jersey and Massachusetts, independents have voted against Mr Obama’s party by margins of two to one and higher. Mr Obama is drifting towards the electoral situation that doomed the presidency of George W. Bush after Iraq, with allies waiting to see if his pet project succeeds or fails, and foes tuning him out altogether.

All politics is a wager on the future. Whether repeal will excite the electorate is partly down to chance. Republicans must base their strategy on what they know now. What they know is that government has passed a society-transforming law of unprecedented unpopularity. When that happens, the business of an opposition is to oppose. All the risk lies in failure to do so.