During President Obama’s administration, they voted to repeal the ACA more than 50 times. They made a big show of every vote, because it fit their ideological narrative. But every time they voted to take health insurance away from the 20 million people who have benefited from ACA, they knew that they had political cover: They knew that President Obama would veto it. So, they had it both ways: They could pretend to repeal ACA, but have the political safety net of knowing that their vote would not take effect, and they could blame it on Obama.
Now, as Republicans prepare to take control of the whole shebang, ideology is about to collide with political reality—on more than one level. And that reality is what may save ACA—and the health and even lives of many people.
One aspect of that new political reality is that the benefits of the ACA are very popular. People may be confused by the nomenclature—Republicans have used the nickname “Obamacare” as a pejorative term—but they do know that they are now getting health insurance that was previously unavailable to them. When they realize that repeal will mean being thrown back out into the cold, even Republican constituents are likely to be very displeased. Are Congressional Republicans so complacent that they would risk the anger of their constituents?
On another level, ACA could potentially be saved by the health insurance industry itself. The Affordable Care Act—for all of its benefits to health-insurance consumers—was also a huge gift to health insurance companies. The individual and employer mandates delivered millions of new customers to health insurers. Profits have soared, despite what some insurers are claiming, as they pull out of healthcare.gov exchanges. If you don’t believe me, just look at the escalating annual salaries and bonuses of the top executives at the biggest health insurance companies. Typically, their salaries rise based on profitability and shareholder value. I doubt that they’d be getting these huge increases if their companies were not profiting.
So, why would health insurers want ACA to go away? Why would they want their industry thrown into chaos, which is what repeal would engender? I don’t think they would
One analyst puts it this way, as quoted in Talking Points Memo:
“Insurers, more than any other business, hate uncertainty, so if there is still a big battle going on about the future then insurers are going to be gun shy,” said Timothy Jost, a professor at the Washington and Lee University School of Law, who is supportive of the ACA.
.And that’s why I think it’s logical to think that the health insurance lobby will work against repeal. As much as I hate to say this, we might all find ourselves rooting for them. And it just might work: Even if our Congressional representatives don’t give a hoot about what their constituents want, they sure as hell care about their donors.
Or maybe this is all just wishful thinking.