Must-read: Jonathan Chait: “Sorry, Conservatives, Obamacare Is Still Working”
Must-Read: Does Ross Douthat not understand that the “Cadillac Tax” is an essential part of every single Republican ObamaCare replacement plan? That while it is an important part of ObamaCare, it is not an essential part of ObamaCare? Or does he understand that element of the situation, but hope that his readers do not? Jonathan Chait reports. You decide!
: Sorry, Conservatives, Obamacare Is Still Working: “Ross Douthat’s Sunday column, as it so often does, offers the least unreasonable iteration…
…of the deranged state of conservative thinking on Obamacare. While no longer collapsing spectacularly, Obamacare is now sadly limping along in disappointing fashion, remaining just healthy enough not to expire…. The worst thing that’s happened to Obamacare is that Democrats have revolted against the Cadillac Tax. President Obama had to agree to delay the tax’s implementation for two years as part of the recent budget deal, in return for lots of good liberal policy (like tax breaks for green energy and low-income families). The Cadillac Tax would be in decent shape if Obama could just use his veto to keep it in place two years from now. The trouble is that Hillary Clinton, pressured by unions, has also come out against the Cadillac Tax. So now you have pro-union Democrats and anti-tax Republicans forming a coalition that looks like it can prevail starting in 2017, regardless of which party wins the election.
So, yes. Bad news for Obamacare, which looks like it has lost one of its many cost-control elements. But as bad as this news is for Obamacare, it’s absolutely catastrophic for Obamacare replacement. Every Republican plan to replace Obamacare relies on the same financing mechanism: limiting or repealing the tax break for employer-sponsored insurance. The Cadillac Tax is a smaller, more painless version of this same policy. If both parties can’t abide a partial rollback of the tax break for the most expensive health plans, they’re never, ever going to go along with eliminating the entire tax break for all health plans. The conservatives cackling over the demise of the Cadillac Tax are delusional — it’s as if they’re watching the backlash against the Iraq War in 2008 with fingers tented, anticipating that this will encourage war-weary Americans to support a land invasion of Russia. The bipartisan support for maintaining the tax break for employer insurance will hurt Obamacare, but it can survive. The Republican plans to replace it would all be wiped out.
The Cadillac Tax debacle illustrates a crucial underlying reality of the politics of health-care reform: Change is incredibly difficult. That is why the United States staggered along for decades with a system that simultaneously spent far more per citizen than any other system in the world and cruelly denied treatment to millions. The compromises in the law are a function of this reality. Obamacare’s drafters could not draw up a blue-sky plan as though they were free to design the system anew. They had to work around an entrenched reality, making the system more humane and efficient without unduly burdening those who feared change. That they managed to pass and implement such a reform in the face of hysterical opposition is a historic triumph, one with which the opposition, five-and-a-half years later, has not come to grips.