Whatever it might mean for Democrats in November, last night represented one of the biggest victories in the history of American liberalism.
During his campaign, President Obama made clear that he wanted to be a transformative liberal leader who "changed the trajectory of America." Once he signs the comprehensive health care bill into law this week, Obama will deliver on that promise, and complete the third major wave of entitlement expansion in America.
Now it's up to conservatives to make sure that the victory is short-lived.
Let's be under no illusions. There's a reason why the battle over this health care bill dragged on for so long and was so bitterly fought. Once a law is enacted that delivers benefits to a given constituency, it becomes very hard to overturn. Not even the conservative icon Ronald Reagan, for instance, was willing to lay a finger on the big box entitlement programs of Medicare and Social Security.
But with that said, there are a number of things unique to Obamacare that make it vulnerable.
While Social Security and Medicare passed Congress with large majorities in both chambers, Obamacare passed without a single Republican vote -- and with 34 defections among House Democrats. The process was tainted by legislative maneuvers and back room deals, and rammed through in the face of overwhelming public opposition.
Furthermore, because Democrats had to make the legislation appear cheaper over the Congressional Budget Office's ten-year budget window, they delayed the bulk of the benefits until 2014, while many of the unpopular aspects of the legislation, such as the huge tax increases, kick in almost immediately.
In the immediate term, no matter what the odds of success, every legal avenue must be exhausted to challenge any and all provisions that have a chance of being overturned in the courts. At the same time, conservatives must be pushing Republican candidates to pledge to work not just to repeal certain aspects of the bill, but, to borrow a line from Jaws, to go after the head, the tail, the whole damn thing. (Sen. Jim DeMint has already announced that this week he would offer a bill to do just that.)
If efforts to repeal or overturn Obamacare fail, then the battle will have to enter the next stage. At some point after it is implemented -- whether this is five years or 10 years from now, there will be another major health care debate. Despite President Obama's promises, premiums will still be skyrocketing and the spiraling cost of health care will be putting a strain on individuals, businesses and the federal government.
When that day comes, liberals will argue that the reason why all of those problems exist is that Obamacare 1.0 didn't go far enough. They'll say that the government needs to spend more money on subsidies, place more regulations on insurance companies, and introduce a public option to drive down costs -- or maybe even go the single-payer route altogether. Conservatives cannot be in a position to lose that argument.
If Obamacare is fully enacted, then conservatives should make sure that Democrats are held accountable for the problems with the health care system. The rising premiums should be blamed on the burdensome regulations that force individuals to purchase the amount of insurance that the federal government dictates they must have, rather than the type that they freely choose. The out of control health care spending should be blamed on the reality that when the government is picking up the tab for something, people tend to spend more. The crushing deficits we'll be facing should be blamed on the accounting tricks Democrats used to hide the true cost of their proposals.
When Americans have to undergo long wait times in doctors offices, when individuals have to file their tax returns each year and present proof of government-approved insurance or pay more taxes, when the private sector has to digest a raft of new taxes and mandates, they'll be more open to hearing conservative alternatives. Keep in mind that this will all be happening within the broader context of the entitlement crisis, with Social Security and Medicare running deficits, and further reinforcing the unaffordable cost of massive government.
In the meantime, conservatives should continue to make the affirmative case that the only way to truly bring down costs and improve quality of care is to have a system that is built around individual consumers making their own choices about how to spend their own money, not one in which health care dollars are controlled by employers and the government.
Obamacare, no doubt, puts America on the road to government-run health care. But as long as there's still a prospect of changing course, conservatives should never stop fighting.
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