Health

Why Obamacare Is On Life Support

Susan Walsh/AP

There's nothing that Democrats want more than to change the subject from Obamacare, despite DNC Chairman Debbie Wasserman Schultz's protestations otherwise. Congressional Democrats don't want to be dealing with a drip-drip of news about premiums going up, patients losing their doctors, and a broken health care website as they face angry voters in 2014. Hillary Clinton doesn't want this issue lingering past the midterms. She hitched her presidential prospects to President Obama's wagon and she's not about to let someone else's crisis damage her presidential ambitions yet again, Even Vice President Joe Biden, who called the health care law a "big f---ing deal," didn't mention it once at a fundraiser last week for North Carolina Sen. Kay Hagan.

Unless the HealthCare.gov website miraculously gets fixed by next month, there's a growing likelihood that over time, enough Democrats may join Republicans to decide to start over and scrap the whole complex health care enterprise. That became clear when even Obama, to stop the political bleeding, offered an administrative fix that threatened the viability of the entire individual exchange market to forestall a House Democratic mutiny the next day. It was as clear sign as any that the president is pessimistic about the odds that the federal exchange website will be ready by the end of the month, as promised.

More than anything, politics is about self-preservation, and the last two weeks provided numerous examples of how public opinion has turned so hard against the law that even its most ardent supporters are running for the hills. It's not just red-state Democrats, like Louisiana Sen. Mary Landrieu, distancing themselves from the law. It's blue-state senators like Oregon's Jeff Merkley and New Hampshire's Jeanne Shaheen -- and top blue-state recruits like Michigan's Gary Peters and Iowa's Bruce Braley, who voted for GOP legislation Friday that the White House said would "gut" the law. Nearly every House Democrat in a competitive district joined with Republicans to threaten the law. Without a quick fix, those ranks will grow.

This tsunami of blowback, which built in just the last month, is unsustainable for Democrats over the long haul. The president isn't just losing his skeptics from the chaotic Obamacare rollout but his allies who stood to gain from the law's benefits -- namely Hispanics, whose approval of the president has dropped more than any demographic subgroup since the problems began. The simplest solution -- if only to stop the bleeding -- is to get the website fixed. (When former DNC Chairman Howard Dean's proposal is to hire tens of thousands of young phone operators to sign people up for insurance -- straight out of a Jerry Lewis telethon -- as he suggested on "Morning Joe," it's clear the website problems are really bad.).

Would President Obama sign a death warrant on his own signature legislation? That's almost impossible to imagine, but it's entirely reasonable that he may not have a choice in the matter. Consider: Despite the White House's protestations, 62.4 percent of the House voted for Michigan GOP Rep. Fred Upton's legislation (261-157), just shy of the two-thirds necessary to override a veto. And consider the House Democrats who voted against Upton's bill but nonetheless released harsh statements criticizing Obamacare. Maryland Rep. John Delaney, in a statement, wrote: "The problem we have currently is that the Affordable Care Act is not working." Added Arizona Rep. Ann Kirkpatrick: "The stunning ineptitude of the ACA marketplace rollout is more than a public relations disaster. It is a disaster for the working families in my Arizona district who badly need quality, affordable health care." Add them into the mix -- the dozens more members who were poised to split with the president until his face-saving press conference -- and you've got all but the hardy Obama loyalists who could end up bolting if the political environment doesn't improve.

Democrats are in better shape on the Senate side, but not by as much as conventional wisdom suggests. Senate Majority Leader Harry Reid will do everything in his influence to protect the president -- and block embarrassing legislation from being voted on -- but not if it means he'll be losing his majority gavel next year. There are 21 Democratic held-seats up in 2014, with 17 Democratic senators running for re-election. Of those 17, 10 are running in states where Obama won less than 55 percent of the vote, approximately the baseline of where House Democrats began splitting with the president on the Upton vote. Excluding Reid, an additional 15 Democrats aren't up in 2014, but represent battleground (< 55% Obama) states where support of the law could become a long-term burden. And then there's California Sen. Dianne Feinstein, who has emerged as a surprising blue-state critic of the law, retiring Montana Sen. Max Baucus, who famously predicted the implementation was shaping up to be a "train wreck," and retiring moderate South Dakota Sen. Tim Johnson.

To overcome a veto, Republicans would need 22 of those 28 winnable votes. Right now, they wouldn't come close. But Reid and the White House may end up relying on swing-state Democrats like Claire McCaskill and Bob Casey to protect the law. If the political mood doesn't improve in short order, will they want to be in that position? And if Republicans retake the Senate in 2015, the political momentum for repeal would only grow.

Even in the face of rough public opinion, the mantra of Congressional Democrats has been to fix the health care law, not cater to Republican extremism to repeal it. But after the president's press conference last week, there's been a palpable pessimism in Democratic strategists' thinking. When I asked one Democratic campaign operative why blue-state Senate candidates like Peters and Braley would support a bill that the White House said would gut Obamacare, the answer was: "We're on our own. We don't care what the White House says. Would you trust them?"

That's the type of thinking that could endanger a health care law that seemed untouchable several months ago. If the administration can't fix the myriad problems ailing the health care exchange website, and more sob stories emerge about people losing or paying significantly more for their insurance, it's an unsustainable formula for Democrats. There's not much time left on the election clock to turn things around. They've shown unfailing loyalty to the president, but unless he manages an unlikely fourth quarter comeback, those bonds could break -- and the results could get ugly.

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// November 26
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