Riding Obamacare to Victory in November

Republicans counting on Obamacare’s unpopularity to deliver them a win in the midterm elections will likely face disappointment.

Republicans counting on Obamacare’s unpopularity to deliver them a win in November seem likely to face disappointment. An honest look at the package shows it’s masterfully designed to deliver a lot of meaningful favors to groups likely to reward Democrats at the polls in November. In particular, senior citizens and middle class families all get immediate benefits while the important costs and externalities resulting from the package won’t take place for some time. Democrats are right to think that people will like the package.

Let’s begin with the well-organized senior-citizen population. Seniors taking advantage of the Medicare drug benefit get an immediate and tangible handout thanks to Obamacare: $250 as a cash rebate to help pay drug costs. Combined with some pharmaceutical industry price cuts and an ongoing generic drug price war that Wal-Mart sparked, seniors’ already falling out-of-pocket drug costs will fall even more before November.  And at least some people will vote for Democrats as a result.

Middle class families get even more. In fact, the plan’s new rules relating to children's coverage and lifetime maximum benefits will instantly alleviate many anxieties that most middle-class families feel about healthcare.  By letting children stay on their parents’ healthcare plans until age 26, hardly anyone with children will have to worry about his or her new college graduate getting healthcare. Rules that forbid healthcare providers from excluding children with pre-existing conditions will impact only a few but they will produce a lot of heart-warming stories about children whose families no longer have to worry about potentially bankrupting medical costs.  The immediate elimination of lifetime coverage maximums, likewise, means that almost no seriously ill person with employer-provided family health insurance will have to worry about exhausting benefits.  Finally, new high risk pools -- a temporary measure until exchanges begin operating in 2014 — will make coverage a lot easier to get for sick people with decent incomes.

Republicans can’t legitimately call for the repeal of any of this: nearly all of the immediate changes are consensus measures that they incorporated into their own healthcare plans. Even better for Democrats, very few will have short term costs. Higher taxes, the potential of waiting lists, and some employers’ decision to drop coverage and the like won’t happen until 2014 or after. The one immediate tax from the plan — a 10 percent levy on indoor sun-tanning — seems unlikely to cause much public anger since, obviously, the tanning industry and its customers didn’t mount an effective campaign against its imposition.

None of this means that Obamacare is good policy. The program is still a big government takeover of the healthcare industry that may diminish the quality of healthcare. I’ll benefit but others may lose. The short term changes, furthermore, seem calculated to get votes by catering to get them from people who have anxiety about medical costs rather than helping those — lower-income single people, small business owners, laid-off workers in their 50s — who have the fewest options under the current system.

Politically, however, the Democrats are right. Once people understand the plan, many Americans will like it.