President Barack Obama says he’s not worried that all the Obamacare fights will kill the law — because people fought the creation of Medicare and Social Security too, and now they’re more popular than ever.
Democrats have always wanted to believe Obamacare would follow the same pattern: Opponents tried to block passage of the new programs, but once they became law, the public saw the benefits and the opposition faded away.
But this time there’s a difference. Political opposition to Obamacare is still as strong as ever, more than three years after it was signed into law.
That means the administration’s task in launching the health care law — the biggest new social program since the creation of Medicare in 1965 — is harder than anything its predecessors had to face.
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Between now and Oct. 1, the Obama administration has to get ready to enroll millions of people, just as Lyndon Johnson’s administration did during the rollout of Medicare. And it has to put the infrastructure in place and make sure the health care industry is ready to participate, just as Johnson’s people did.
But on top of all that, Obamacare has a huge extra layer of political hurdles LBJ didn’t have to worry about like battling Congress for money, persuading Republican governors and legislatures to go along, and quieting the well-funded outside groups.
Republicans insist that this is what Obama and the Democrats signed up for when they decided to push ahead without Republican votes. “It’s very short-sighted to think you can do something this big on a partisan basis,” said Senate Minority Whip John Cornyn (R-Texas). “At some point, you’re going to need bipartisan support for the implementation.”
Democrats insist that they tried to win GOP support — especially Senate Finance Committee Chairman Max Baucus, who spent months trying to negotiate a compromise with Senate Republicans — and they wouldn’t bite.
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They also say it’s hardly the first time a major health program was created by one party. The Medicare prescription drug program, created under the George W. Bush administration, passed Congress in 2003 almost entirely with Republican votes, including a pre-dawn House vote that was held open for nearly three hours while GOP leaders twisted arms.
And Obama administration officials don’t buy the comparison to either program. The real model for Obamacare, they say, is the Massachusetts health reform law — the one signed by Mitt Romney. It inspired the structure of Obama’s health care law, and it’s now so popular in that state that repeal isn’t even a remote possibility.
But at least one veteran of the launch of Medicare — Joseph Califano, one of LBJ’s top domestic aides at the time — isn’t too surprised with the fallout of the decision to move ahead on Obamacare without GOP support.
Even though LBJ had huge Democratic majorities in 1965, he insisted that “we have to shoot for half the Republican votes, because if we don’t, they’ll drive us crazy — they’ll kill us on appropriations, they’ll kill us with the Republican governors,” recalls Califano, now the founder and chairman emeritus of the National Center on Addiction and Substance Abuse at Columbia University. It was a different GOP back then, but LBJ still managed to win half of the House Republicans and nearly half of the Senate Republicans.
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“I don’t know if Obama’s problem was the incalcitrance of the Republicans or his inexperience — probably both,” said Califano. But whatever the reason for the failure to get Republican buy-in, he said, “they’ve got a hell of a difficult couple of years ahead.”
One Obama administration official acknowledged that the ongoing Republican resistance is “unprecedented, and it creates new challenges.” But the political mood is very different in the states that are trying to implement it, the official said, and there will be “enormous successes” in the states that give the law a genuine effort — “and there will be many of those,” citing California, Maryland, New York and Nevada.
But former administration officials acknowledge that the Obama administration never anticipated the battles would drag on this long. One said the view within the administration was that, once the Supreme Court upheld the law last year, “it would be a new environment” and the law would become more accepted.
The congressional fights are an enormous problem. Obama needs Congress to drum up money for the Department of Health and Human Services and the Internal Revenue Service for next year. He’s has asked for $ 1.5 billion for staffing and other needs. But the Republicans are facing strong pressure within their ranks — including the high-profile voices of Marco Rubio and Ted Cruz — to cut off the funding even if it means a government shutdown this fall.
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But that’s only the beginning of the problems. House Speaker John Boehner has promised to hold more votes to chip away at the law, even after the House has already held 40 votes to roll back some or all of it. And the investigations and hearings will continue in the House, pouncing on everything that goes wrong with the law — including the latest problems with the “data hub” for checking people’s eligibility for coverage, which has had so many delays it’s not clear it will be ready for prime time on Oct. 1.
The data hub, which is supposed to allow real-time checks of an Obamacare customer’s income and other information, is one example of a logistical problem that will get an even harsher spotlight because of the ongoing Republican resistance. A recent report by the HHS inspector general’s office said that because of all the delays, the official security authorization for the hub is now expected on Sept. 30 — one day before enrollment begins.
Obamacare"s hurdles higher than Medicare"s
