The Republicans' rabid loathing of the ACA is more than just hatred towards Democrats or the mere lust for power or even racism. Their whole philosophy of business vs. government is under attack.
Since its inception, the Republican party has supported business interests, often to the exclusion of everyone else. In the recent past they have branched out to include the religious right and small-government libertarians, but in the main the GOP has willingly been the tool of banks and the largest businesses.
As ideological cover for this prejudice, they have championed economic and social theories which have left a diminished role for government and put majority control of the economy in the hands of the corporatists. Only business leaders, they have maintained, should make the decisions which affect all our lives. Government should stay out of it and be well behaved.
It is their fundamental belief that the business community should be unregulated, uninhibited, and unblamed no matter what the consequences. This conviction is under assault by the introduction of the ACA, and this fact well explains their fervent attacks. What they are keen to avoid is the revelation that history has proven their philosophy to be false and their agenda to be ruinous. Their refutation started in one particular state.
When Romney, inspired by the conservative think tank the Heritage Foundation, introduced health care reform in Massachusetts, the dynamic and business model of the health insurance providers was profoundly altered. Up to that point they were free to charge as much as they could get away with, often with little competition. If high rates meant that many citizens could not afford health insurance, at least profits were high.
As with the ACA, Romney's plan introduced competition balanced with greatly increased membership, so that insurance companies were offsetting lower rates with volume, so to speak. This new business model meant that nearly everyone in the state was able to obtain good, affordable policies, and the insurance companies were able to maintain high profits. Win, win, eh?
The critical thing about this new business model is that it was never chosen by business, but imposed by government. It is doubtful that the insurance companies would have chosen to run their businesses in this way if not forced by law. This is the foundation for the unspoken dread animating much of the current Republican opposition to the ACA. Government action worked. It must be particularly irksome that the whole plan was thought up and implemented originally by Republicans.
This conflict over the ACA points up a fundamental difference between the D's and the R's over the necessary role of government. Republicans, in spite of the lessions of history, insist that only business leaders should be determining all the options no matter what the collateral damage. Democrats hold that prudent and restrained government action can maintain business interests and benefit all of the people at the same time and that this is desirable.
The Republicans think that they can work opposition toward the ACA into the issue which will win it all in the next election, but nearly a year is a long time to keep that pot simmering. In that time the program will overcome initial glitches and result in vastly expanded coverage, but they will likely develop a screaming fit over something else. This is how Republicans hope to win. Democrats should be aiming toward campaigning over what is the fundamental issue at stake.
What is the proper role of government in our lives? Should it be a mere lapdog to business interests, or should it be implementing prudent laws when shown to be necessary in order to benefit all the American people? This is an issue Republicans will not want to face.