Now that we've ended the two-week- old government shutdown and avoided the calamity of a default on our sovereign debt obligations, political pundits are debating who won and who lost. The better question is, what should Republicans do next?
It's charitable to say that Republicans “didn't win” this battle, as House Speaker John Boehner conceded. Those who insisted Obamacare must be defunded ended up with only a token concession from Democrats: a requirement that the secretary of health and human services “certify” that those receiving the Patient Protection and Affordable Care Act's government subsidies to purchase health insurance are actually eligible for them.
But did Republican tactics permanently compromise their ability to capitalize on the deeply flawed rollout of Obamacare, and what many analysts (myself included) believe will be its deleterious impacts on the U.S. health-care system? Not necessarily. Republicans can still use Obamacare's failings to their advantage, but it will require a disciplined, realistic approach. And it means recognizing the impossibility of large- scale changes to the law while Barack Obama is president.
First, last week's agreement to reopen the federal government and raise the debt limit means we will find ourselves back in this situation again early next year. The temptation among some conservatives — particularly those who fought to defund Obamacare — will be to again make extravagant demands of Democrats in exchange for either keeping the government open or raising the debt ceiling again.
The tactic didn't work this time, and it won't work next time, either. President Obama and Senate Democrats have made it clear that they are not only unwilling to compromise on broader Republican demands to delay or defund the law, but also unwilling to budge on more limited changes, such as delaying implementation of the individual mandate or putting off some of the tax increases that help to fund Obamacare. Republicans would be wise to completely decouple the debt-ceiling and government- funding issues from their efforts to alter or eliminate Obamacare.
Second, the best way for people to see how bad the health- care law will be is, in many respects, to get out of the way. Two of the Obama administration's most prominent (and politically popular) promises about the law — that it would reduce health-insurance premiums and that people who like their coverage can keep it — will continue to go unfulfilled.
Avik Roy and his colleagues at the Manhattan Institute have estimated, for example, that 27-year-old men who were able to purchase basic health-insurance plans before Obamacare will pay, on average, almost 100 percent more for similar plans next year. Similarly, 27-year-old women will see their premiums increase an average of 55 percent. The news isn't much better for 40-year- old men and women, who will also see substantial increases in their premiums next year because of the law. Other studies have similarly concluded that Obamacare will drive up premiums not only for individuals purchasing insurance, but also for many small employers who provide coverage to their employees.
A number of additional Obamacare provisions threaten to displace millions of Americans from the health-care coverage and doctors they know and like. This is because Obamacare gives employers financial incentives to scale back or terminate coverage, and it places additional coverage mandates on individual health-insurance plans that will result in narrower networks of providers and hospitals, or the elimination of existing plans.
Finally, Republicans must remain focused on the damage that will be done by the entirety of the law rather than trying to engage President Obama and his allies on individual components of the law. There are components of Obamacare that are very politically popular, such as the blanket restriction on insurers denying coverage to those with pre-existing medical conditions and allowing children up to age 26 to remain on their parents' health-insurance plans.
Republicans must not get bogged down in debates about the merits of individual elements of the law. Instead, our critique must be about the law in its entirety — the negative impact it will have on our health-care system and the way in which it substantially increases costs to pay for the benefits it claims to provide.
Our party squandered a golden opportunity this month to focus the American people on Obamacare's shortcomings and the ways in which its implementation and rollout has been an utter disaster. Over the next several months, they will have new opportunities to describe, demonstrate and highlight just how bad the law is. If they play their cards right, and bring public pressure to bear on the president and other supporters of Obamacare, they might actually force Democrats to consider the wisdom of standing behind a law that's clearly failing.
Lanhee Chen is a Bloomberg View columnist and a research fellow at the Hoover Institution at Stanford University.