As the government shutdown drags on and America creeps ever closer to yet another economic catastrophe, it is important to clarify a few things about the sole focus of House Republicans’ full-scale obstruction. Most realize that the government shutdown is a direct result of a desperate effort to stop the implementation of the Affordable Care Act, but it is worth explaining exactly what it is that extremist Republicans are trying to stop.
When the ACA was developed, Democrats knew that the liberal ideal of a single-payer (i.e. government controlled) health care system similar to those in Europe or Canada would not receive the political support from Republicans that was necessary for passage. Despite the fact that the single-payer systems in developed countries have been measurably cheaper and deliver better outcomes than America’s pre-ACA system, then-candidate Obama and his team decided to move ahead with a pragmatic plan instead of a politically hopeless idyllic proposal to win votes.
In order for health care reform to work, Obama’s strategists knew that it would need to draw on conservative philosophy, namely the unquestionable righteousness of the capitalist free market. Instead of restricting Americans’ choice when it came to their health care insurers, the Affordable Care Act would have to allow consumers to enter into a free market where competition would theoretically drive down costs. This was not a problem; Massachusetts’ plan had already done something similar under a Republican Governor, and it was proving to be successful.
An even more critical component to the success of the Affordable Care Act was the reality that it wouldn’t work at all unless everyone in the country participated by purchasing health insurance. (This is the same reason group plans offered by employers have always been cheaper than private individual plans; there is strength in numbers when it comes to purchasing power—especially with insurance.) Fortunately for Obama, conservative ideology had long valued individual responsibility. Since not carrying health insurance is irresponsible—because the high costs of emergency care are ultimately passed on to responsible people with insurance—conservative Republicans would have to agree with what would be known as the individual mandate. And in fact, they had been in agreement for years.
The most prominent conservative think tank, The Heritage Foundation, issued a report supporting the individual mandate in 1989. After that, a number of Republican politicians supported the individual mandate as an alternative to Clinton’s health care reform efforts in 1993. So the individual mandate should not have been a problem politically. And let’s not forget, Massachusetts’ plan had already done the exact same thing under a Republican Governor, and it was proving to be successful.
When the Affordable Care Act made it to Congress following Obama’s inaugural election, it was not exactly rammed down the country’s throat as many Republicans like to say. In fact, after many debates and committee hearings, “more than 160 Republican amendments were accepted” to the bill. The entirety of the Affordable Care Act was then passed by majority votes in both the Senate and the House. It is true that the bill had been created in the Senate via a controversial tactic which Republicans still denounce as illegitimate, but that aspect of legitimacy was never formally challenged, as it is without merit. The individual mandate was formally challenged and upheld by the Supreme Court.
Now Republican members of an extremist faction have shutdown the entirety of the federal government (a government in which they don’t believe anyway) all in the name of defunding, delaying, and repealing the President’s signature achievement. An achievement they claim is unaffordable despite its self-funding nature. An achievement they claim is “as destructive to personal and individual liberty as the Fugitive Slave Act of 1850” despite the fact it is disproportionately supported by black Americans. An achievement they claim is uncompromising tyranny despite the law’s lynchpins of Republican ideology.
It is painfully clear that certain members of today’s Republican Party wouldn’t be able to compromise even if someone did it for them, which happens to be exactly what President Obama did when he and his staff created the Affordable Care Act.