Jonathan Chait | What trainwreck? Obamacare’s working great

Scanning over the right’s Implementation Train Wreck drumbeat, the striking thing is that, just as when the law was passed, how few conservatives understand even vaguely how the law works. John Stossel’s contribution here is typical — his argument does not involve any deeper analysis than Obamacare-is-government, government-is-bad. Most conservatives seem to be under the impression that the law would rip apart existing insurance arrangements, which explains their bizarre, muddled attempt to “apply” Obamacare to Congress, which already has employer-provided insurance and like most Americans should not be affected by the law.

It is certainly true that implementing the law is going to be complicated. It’s not just that new government programs are complex — any new large initiative is complex. Rolling out a new product is hard, and it would be harder if half the retail managers were working for a rival firm. Insurance is also inherently complicated. Signing up for employer insurance is a pain in the neck, and it will also be a pain when the government is doing it. Republicans will be able to exploit all these pains, snafus, and breakdowns, and possibly create a drumbeat of failure and disorganization in the news media.

But what I don’t think they realize is that the constituency they’re mobilizing consists almost entirely of people that Obamacare is trying to help: uninsured people whom the government is trying to enroll in subsidized exchanges. The Obamacare debate has mainly centered on the people or groups that will give something up to pay for the new coverage — Medicare providers, people with very high cost insurance plans, and so on. It has ignored the interests of the uninsured, which is typical — the uninsured are a politically disorganized and powerless constituency, which is one reason why they have had such a rough go of it.


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