Of all the political issues that divide us, health care is the one with the greatest impact on ordinary Americans’ lives. If Democrats hadn’t managed to pass the Affordable Care Act, around 20 million fewer Americans would have health insurance than currently do. If Republican-controlled states hadn’t refused to expand Medicaid and generally done as little as possible to support the act, national progress might have tracked progress in, say, California – so another 7 or 8 million people might have coverage.
You obviously know where I stand on this political divide. But I’m starting to believe that I misjudged Republican motives.
You see, I thought their behavior was cynical and strategic: They opposed Obamacare because they thought there was political mileage in scaring people about change, and also in denying Obama any successes. Oh, and their donors really hated the taxes on the rich that pay for the ACA’s subsidies. And right up through 2016 they could hope to convince voters that they had a secret plan for something much better than Obamacare.
Indeed, all of these things surely played a role in GOP health care strategy. But at this point they’ve clearly lost the political argument. In 2017, Republican attempts to repeal Obamacare made it clear to everyone that their party didn’t have any better ideas, and never did; everything they proposed would have devastated the lives of millions.
Then health care became the top issue in the 2018 midterms, and voters who considered it the most important issue went Democratic by a three to one margin.
So you might have expected Republicans