Sen. Cruz's epic tantrum this week notwithstanding, the truth about the Affordable Care Act is far more mundane: The plans in question are administered by private companies, and the role played by the federal government is generally limited to subsidizing the cost of plans, regulating what they must cover and at what cost, and using the tax code to create incentives for people to obtain insurance and for employers to provide it. Witnessing a Koch-funded front group peddle falsehoods to the American public is nothing new. Watching them betray their own principles in the process, however, is something different altogether.
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As Joan McCarter has pointed out, there's a certain irony and hypocrisy in a conservative group using "rape-by-government" imagery to attack a signature Democratic achievement. Conservative legislatures and governors across the country, after all, have seen no problem with mandating an invasive transvaginal ultrasound procedure before obtaining a legal abortion, regardless of whether a woman or her doctor believe such a procedure is medically necessary. When it suits a particular convenience—that of making a legal abortion as difficult as possible to obtain—conservatives seem to take pride in using the power of government actually forcing women to have their private parts penetrated against what otherwise would be their will.
While that discrepancy could be attributed to the perhaps temporary supremacy of the theocratic wing of conservatism over the economic one, all sides of the conservative moment love to preach about the ethic of personal responsibility. Conservative opposition to social welfare programs is often rooted in the idea that the existence of such programs encourages those who use them to abdicate personal responsibility for their own lives in favor of being taken care of by handouts from government entities. Conservatives could reasonably make the same argument regarding those with no health insurance: We, as a society, are generally unwilling to let the uninsured die from a catastrophic illness or injury regardless of their ability to pay, and the resulting costs are then passed onto society as a whole. Those who are insured, meanwhile, could be seen in this worldview to have taken personal responsibility for their lives, and are thus not being a larger burden to society.
And yet, the ads by Generation Opportunity seek to achieve the exact opposite outcome: telling the healthy young people upon whom the exchanges depend for solvency to forgo getting insurance and live with the risk of being uninsured instead:
Their message: You don’t have to sign up for Obamacare. And they want students to sign a pledge not get insurance plans set up by the law.Why would a conservative group seek to encourage people to make irresponsible choices? As David Atkins wrote, the stakes actually couldn't be higher:
“What we’re trying to communicate is, 'No, you’re actually not required to buy health insurance,'” Generation Opportunity President Evan Feinberg told Yahoo News in an interview about the campaign. “You might have to pay a fine, but that’s going to be cheaper for you and better for you.”
Under the law, those who do not sign up for health insurance in 2014 will be required to pay $95 or one percent of household income through the Internal Revenue Service. The fine will increase after that. Generation Opportunity activists will try to convince young people that it’s better for them to pay the fine, even if it means lacking coverage.
But not so today. Today, Republicans have placed all their chips against the Affordable Care Act. Not for a generation or more will Republicans be able to credibly claim to voters that they want to "protect" Obamacare, after voting 42 times to repeal it. Nor for a generation or more will they be able to credibly praise President Obama compared to, say, a presidential candidate Elizabeth Warren if she promotes true single-payer healthcare. It's hard, after all, to claim that there's anyone worse than the Communist Kenyan AntiChrist. Nor again will it be possible to "rebrand" Obamacare as anything other than Democratic President Barack Hussein Obama's healthcare plan.The Affordable Care Act will not be repealed until and unless the Republican Party seizes control of both the presidency and both chambers, and the earliest that can happen is in 2017. The exchanges will have long been operational and familiar to the American public at that point. Republicans have staked their reputation on hatred for health insurance reform, and one of their only reasonable path forward in absence of prospects to repeal the law is to figure out how to make it fail. And movement conservatives will resort to violating every single principle they have in search of that outcome.
No, the battle lines here are set. Either Republicans make the President's signature healthcare plan a failure, or Republicans see their brand badly tarnished as voters are reminded daily of the positive effects of a healthcare plan Republicans opposed, enacted by a President Republicans despised, bearing that President's own name.
Repealing, defunding and sabotaging Obamacare isn't an ideological statement by Republicans now so much as a survival mechanism.