Make no mistake: Health care will be on the ballot this November. But not in the way ardent progressives imagine.
Democrats running for president have spent a lot of time debating so-called Medicare for all, with some supporters of Bernie Sanders claiming that any politician who doesn’t demand immediate implementation of single-payer health care is a corporate tool, or something. But the reality is that whatever its merits, universal, government-provided health insurance isn’t going to happen anytime soon.
I say this because even if Democrats take the Senate in addition to the White House, the votes for eliminating private health insurance won’t be there; nor will the kind of overwhelming public support that might change that calculus. In practice, any of the Democratic candidates — even Sanders — will, if victorious, end up building on and improving Obamacare.
On the other hand, if Donald Trump wins, he will probably find a way to kill Obamacare, and tens of millions of Americans will lose health coverage.
Let’s talk for a minute about Obamacare. There’s a sort of perverse alliance between Republicans and some progressives, both of whom are determined, albeit for different reasons, to see the Affordable Care Act as a failure.
These downbeat assessments are made easier by the fact that the A.C.A. left much of its implementation up to the states, and that national performance has been held down by states that have done their best to sabotage health reform.
But look at states that have tried to make the law work, and what you see is a huge if incomplete policy success. Take the