WASHINGTON — Roughly 48 million Americans remain without health insurance, a tally that could drop dramatically in coming months. So, for foes of the Affordable Care Act, time is running out.
Programs such as Social Security, Medicare, food stamps and welfare have a way of becoming entrenched and politically untouchable. And Republicans know it, adding urgency to their efforts to kill the landmark health care law, which offers subsidies for millions to help pay for insurance.
“It’s easier to kill a vampire than a bad government program,” said Rep. Pete Olson, R-Texas, invoking a bit of conservative folk wisdom from Phil Gramm, the former Texas senator. “Once this thing gets up and running, it’ll be tough to kill, just like all government programs are. That’s why there’s some sense of urgency.”
Republicans who dug in hardest ahead of the government shutdown, demanding that Congress defund the health care law, warned over and over that once the law takes hold, there may be no turning back.
“The Obama administration knows that in modern times, no major entitlement program that’s been implemented has ever been unwound,” Sen. Ted Cruz told Texas reporters in late July. “Their objective, I believe, is to get as many Americans as possible addicted to the subsidies, addicted to the sugar, in order to entrench Obamacare as a permanent feature of our economy.”
At Families USA, a left-leaning group that supports the law, executive director Ron Pollack said Wednesday that he agrees with critics who expect political momentum and public opinion to make it exceedingly hard to overturn.
“If they had confidence it was going to fail, why put much effort into stopping it? This is really going to help people,” Pollack said. “That’s why they have reached a fevered pitch at this moment.”
Oct. 1 was a key milestone, as uninsured Americans began signing up — albeit with many glitches — through online marketplaces. Their coverage will take effect Jan. 1.
“They recognize that it’s a point of no return,” Pollack said, “and as people get the benefits and get the protections, they’re going to value this very highly, and they will be very mad at any politician who takes this lifeblood away from them.”
About a third of the population has a pre-existing medical condition. For someone with a history of asthma or diabetes or cancer, the law protects them from being denied coverage, charged more, or getting kicked off insurance.
Millions of Americans will enjoy subsidized premiums; benefits taper out but even a family of four earning up to $94,200 would get help.
Then there’s the Medicaid expansion. Texas along with about half of all states refuses to participate; Gov. Rick Perry says the state budget can’t handle it. Elsewhere, this element of the law will cut dramatically the number of poor Americans without health coverage.
With the government’s nonessential functions shut down and the nation’s credit line due to run out on Oct. 17, the budget showdown has merged with a fight over the debt ceiling. Conservatives are trying to keep the focus on the health care law.
“The only acceptable way out of this is some sort of deal that funds the federal government without funding Obamacare,” said Michael Needham, chief executive of Heritage Action for America, told reporters Wednesday. The tea party group worked with Cruz to generate demand for a defunding showdown.
He doubts the new health care program will be popular, because it’s too costly and “fundamentally unfair.” But “giving out billions of dollars in subsidies is going to be a difficult thing to roll back,” he acknowledged.