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November 15, 2013 9:07 AM That Was the Week That Was

By Ed Kilgore

In his National Journal column today, Ron Brownstein summed up the developments of this week in politics, and their potential implications, about as well as anyone could ask:

This resurgence of resistance [to the Affordable Care Act] has emboldened Republicans and significantly increased the odds that the 2016 GOP presidential nominee will again run on repealing the law, as Mitt Romney did in 2012. It has also unnerved the president’s party. The Democratic confusion was visible in former President Clinton’s suggestion this week that Obama should allow consumers receiving cancellation notices in the existing individual market to keep their current plans.
Because the individual market now largely excludes the sick (through rules such as denying coverage for preexisting conditions), the relatively modest number of Americans who use it tend to be healthy. If they are allowed to remain outside the new system, the more comprehensive policies sold on the exchanges could tilt too heavily toward the old and sick. And that, notes Jonathan Gruber, a Massachusetts Institute of Technology economist, “would generate a huge [premium] rate shock in 2015” that could further discourage the healthy from enrolling and risk a fatal downward spiral.
Even if the former president intended to distance Hillary Rodham Clinton from the backlash with his remarks, his remedy would expose her, and other Democrats, to greater risk that the new system will sink entirely and submerge them all in future elections. Helping those losing policies to afford new coverage makes more sense for Democrats than allowing them to remain outside the system.
As the health law teeters, the stakes are so great because the struggle encapsulates each party’s core argument. It embodies the Democratic belief that society works better when risk is shared—between young and old, healthy and sick—and government intervenes in private markets to try to expand both security and opportunity. The fury of the Republican resistance reflects the party’s insistence that markets work best unfettered, that centralized government programs cannot achieve their goals, and that Democrats are unduly burdening the “makers” to support (and politically mobilize) the “takers.”

As Brownstein indicates, Democrats are crazy if they head to the hills now, or push for “fixes” to the largely political problem of individual policy cancellations that make “rate shock” more likely and threaten the whole law. In his defense, Bill Clinton’s comments that touched off the latest “fix” frenzy among a small but crucial segment of Senate Democrats and forced Obama’s hand, were originally focused only on a very small group of young and healthy people with existing insurance policies who don’t qualify for Obamacare subsidies. But with the smell of panic in the air amidst the unholy howls of impending triumph from the most reactionary of the conservative wolf pack, it’s not a great time for nuance.

Democrats better hang as tough on this issue as they possibly can. As Brownstein says, the stakes are very high.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.

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