Despite threats, Obamacare still winning

Another year gone. Another year of the Affordable Care Act’s opponents moving further from – not closer to – getting their way on health care.

How so? This week’s omnibus deal, which was approved Friday by the U.S. House and Senate, provided a clear view once again of the uphill climb Republicans face in repealing Obamacare.

The omnibus negotiations never included talk of repeal, because that’s a non-starter among Democrats and the White House. Instead, Republicans were left to chip away at the health law they hate.

They did so by postponing two important Obamacare taxes – the Cadillac tax on expensive health plans and a tax on the sale of some medical devices. Republicans (and some Democrats) dislike the taxes because of the burden they put on big business and the medical industry. Republicans also don’t mind eliminating two revenue sources for Obamacare.

The provision restricts Obamacare’s “risk corridors,” which give money to insurers who are losing money because they have too many sick people on their rolls. Now, the administration will be able to pay only a fraction of what insurers expect, causing some premiums to rise and some insurers to drop out of Obamacare altogether.

That pain was offset at least some in this week’s omnibus with a one-year suspension of Health Insurance Tax (HIT), the Affordable Care Act’s tax on insurers. The HIT suspension also should mitigate some of the rise in insurance premiums.

This back-and-forth parrying will surely continue, at least in the short term. Republicans will try to score political points by trying to ding Obamacare. Democrats will ward off maneuvers that might truly damage the health care law.

Meanwhile, Obamacare will continue to become a more settled part of our health care landscape. Already, the ACA has resulted in a sharp decline in the number of uninsured, and Americans have come to rely upon the security it provides against job loss and major illness. That’s why enrollment has spiked to 6 million as of this week, the president said Friday.

And oh yes, Obamacare has come in under cost projections.

Even if the presidency changes parties, Republicans know that any Obamacare repeal will have to be accompanied by an alternative health plan. That alternative will need to ensure that the insured remain insured, and that their policies include the benefits Obamacare now provides. Anything else is political folly.

In that way, Obamacare has already won. It’s changed the expectation – and therefore the reality – of health care. If only Republicans would acknowledge that reality and work to make the Affordable Care Act better, instead of engaging in another year of trying to move us backward.

This story was originally published December 18, 2015 at 5:56 PM with the headline "Despite threats, Obamacare still winning."