Obamacare: Is the GOP raising the white flag?

“Washington’s repeal-Obamacare crowd is feeling a little lonely these days,” said Jennifer Haberkorn in Politico.com. First, the Supreme Court betrayed them by finding the Affordable Care Act constitutional. Now Republican governors in eight states have “bowed to political reality” and agreed to accept the Affordable Care Act’s optional Medicaid expansion. The biggest defection came last week in Florida’s Gov. Rick Scott, whose capitulation was followed this week by New Jersey’s Gov. Chris Christie. For Scott to be “waving the white flag” is particularly galling, said Philip Klein in WashingtonExaminer.com. A former hospital executive and Tea Party favorite, Scott was among the ACA’s fiercest opponents, at one point spending $20 million of his own money on ads denouncing President Obama’s “job killing” health-care reforms. But now Scott has given up the fight, claiming he could not, “in good conscience, deny the uninsured access to care.”

Conscience has nothing to do with it, said The Wall Street Journal in an editorial. This is all about money and political self-preservation. As an inducement for states to cooperate in providing universal health care, the ACA calls for the federal government to pay 100 percent of the cost of extending Medicaid to millions of the uninsured for the first three years (after which it tapers to 90 percent). Scott and Christie, facing budget pressures, couldn’t resist all that free “federal magic money.” But their cave-in doesn’t mean the fight against Obamacare is over. When the full ACA kicks in next year, small businesses will start having to pay 20 to 30 percent more for their employees’ coverage, at which point this huge new entitlement “may explode on the launchpad.” Besides, not all Republican governors have become collaborators, said NationalReview.com. At least 14 states have opted not to establish in-state insurance exchanges, leaving that daunting task to Washington. The dream of repealing Obamacare in full may be over, but “the law’s own design flaws may yet undo it.”

We don’t need to repeal Obamacare to subvert it, said Douglas Holtz-Eakin and Avik Roy in Reuters.com, Once the ACA starts driving health-care spending to “unsustainable levels,” Republicans will have a chance to reshape our health-care system to resemble Switzerland’s, which provides universal coverage at less than half the cost of the U.S. system. The Swiss secret: Citizens receive subsidies to buy their own private health-insurance plans in a free-market system that encourages competition. The architecture for a U.S. version of that system will be created by the ACA’s insurance exchanges. If Republicans work to unburden the exchanges of the ACA’s “costly mandates and regulations,” Obamacare can be transformed into a “fiscally sustainable” program that gives individuals a choice over competitive health plans. “In other words, everything that conservatives have always wanted.”

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“Right!” said Jonathan Chait in NYMag.com. Obamacare is actually based on a Republican idea from the early 1990s to solve the problem of uninsured “free riders” on the system. Too bad Republicans didn’t notice this until they spent the past few years “screaming about socialism.” Conservatives hated Obamacare for one reason only, which is that it ensures that all Americans have access to health care. The fact that the Republicans’ focus is now shifting to improving Obamacare shows they finally “understand that the struggle to preserve ‘American exceptionalism’ in health care—America’s standing as the sole advanced democracy without universal citizen access to medical care—is over.”