What a difference eight years make. On the eve of the midterm elections of 2010, career-ending defeat loomed over dozens of Democratic congressman who’d voted for the Affordable Care Act, derisively branded “Obamacare” at the time. In 2018, Republicans, the current target of voter rage, are scrambling to reassure constituents that they’ll save — even extend — key features of the ACA.
For example, last week Idaho’s right-wing Republican Gov. Butch Otter endorsed a ballot measure that would extend Medicaid coverage to more than 60,000 of his state’s low-income residents. The federally funded expansion of Medicaid, let us recall, was one of the ACA’s most contentious components. And, in the end, every single Republican congressman and senator voted against the final bill. Now a Republican governor in Idaho is all for it.
As Barack Obama’s presidency has begun to recede into the mists of time and the deliberate misrepresentations about the ACA have subsided, a majority of Americans have warmed to the healthcare law, and a supermajority to some of its particulars. That took some time.
In 2015, when the Supreme Court upheld the act’s constitutionality, Chief Justice John G. Roberts Jr. consoled his fellow conservatives by inserting a proviso in the court’s decision that said states didn’t have to extend Medicaid eligibility. In near lockstep, Republican-controlled states refused the Medicaid extension — and the federal funds that went with it.
Tuesday, three of those rock-solid red states are voting on initiatives to do an about-face: Idaho, Utah and Nebraska. There hasn’t been public polling in Nebraska, but surveys in Idaho and Utah show the Medicaid expansion measures well ahead. Also on Tuesday, Montana will vote on whether to continue the Medicaid expansion it adopted in 2015. If all four measures pass, that would leave just 11 states where Republican leaders have denied federally funded medical insurance to their fellow citizens.
Medicaid expansion isn’t the only piece of Obamacare that Americans have come to support. Democratic candidates across the nation are pounding the drum on protecting people with preexisting conditions. The issue appears to be working. Polling from the Kaiser Family Foundation this summer found that 63% of Americans — and 49% of Republicans — said a candidate’s position on guaranteeing coverage for preexisting conditions was either “the single most important factor” or a “very important factor” in determining their vote.
The poll also showed that a majority of Americans (including 58% of independents) didn’t want the Supreme Court to strike down the ACA either. (Earlier this year, a group of Republican attorneys general, led by Ken Paxton of Texas, revived their efforts to have the ACA declared unconstitutional.)
There are three lessons to draw from this. The first is that when right-wing media and opportunistic Republicans aren’t filling the public’s heads with endlessly repeated lies, the American people can figure out what’s actually good for them. When the ACA was still before Congress, the right’s allegations that it would create “death panels” to determine who should live and who should die were constantly polluting the airwaves. Eight years later — with no death panels in sight and with the right now directing its falsehoods at refugees from Central America — the merits of Medicaid expansion and the preexisting condition guarantee have become obvious to most Americans.
The second lesson is that it was never the “care” part of Obamacare that really roused the right’s anger. It was the “Obama” part. An African American Democratic president was an affront to the right’s sense of national identity, so all of Obama’s handiwork came to be viewed as an affront as well. And if Americans were insufficiently outraged, the Murdoch empire and its ilk were there to stoke their anger with deceitful allegations.
And third, left to their own devices, Americans support progressive economic ideas such as an adequate safety net, guaranteed access to medical care, affordable college and living wages. That’s why the right has abandoned its old fever dreams of repealing Social Security and Medicare. That’s also why some Republican congressmen are about to learn that voting to repeal Obamacare over and over again is about to speed them to an early retirement after election day. Voters, it appears, are convening a political death panel of their own.