July 8, 2015 Understanding the politics of the president's health care law has never been complicated. It was barely passed through Congress despite huge Democratic majorities in 2009, became the driving force behind the GOP's takeover of the House in 2010, and again was the leading issue Republicans campaigned on to retake the Senate in 2014. Nearly 15,000 advertisements aired about Obamacare in the last week of last year's midterms, and94 percent of the messaging was negative. One week later, Republicans won nine Senate seats and netted their largest House majority since the 1920s. For Republicans, it has been the political gift that keeps on giving.
Yet even though public opinion remains unfavorable towards the law, Democrats remain in denial about its political standing. Its supporters rushed to declare the issue closed for debate after the Supreme Court's ruling last month that federal subsidies remained constitutional. "After more than 50 votes in Congress to repeal or weaken this law, after a presidential election based in part on preserving or repealing this law; after multiple challenges to this law before the Supreme Court—the Affordable Care Act is here to stay," President Obama proclaimed after the ruling.
In reality, the law will likely remain a pivotal element of the GOP's argument against Hillary Clinton in 2016—and for Republicans in the battleground congressional contests. Adding to the political momentum for opponents of the law are unpopular mandates and provisions that were delayed after the midterms but will be taking effect as the presidential election draws closer. Most significantly, leading health insurance companies are seeking significant increases for premiums, as they're finding their customers are sicker than expected. At the same time, federal "risk corridors" established to help cover their rising costs are expiring and not likely to be renewed by a cost-conscious Congress.
Even the Obama administration, by its own actions, has demonstrated the unpopularity of its signature law. In responding to political resistance to Obamacare, the White House purposely delayed critical elements of the law until after the 2014 midterm elections—when Obama would be heading out of office. Medium-sized businesses won't be required to provide health insurance to their employees until next year—a mandate that opponents of the law argued would be overly burdensome and drag the economy down. Consumers who received extensions for their old health care plans won't be able to keep them past 2017, renewing the prospect of another flood of politically-damaging cancellation notices. The funding streams to the insurance companies—or bailout, in the GOP parlance—that would help reduce consumer costs are unlikely to be maintained, given how expensive it would be. The theory was that if they kept buying time, public opinion would slowly get with the program regardless of its fiscal sustainability.
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