The Affordable Care Act has exceeded expectations where ever we have measurements, such as in people signing up, despite the Congressional Budget Office reducing their prediction after the computer problems in October. The Republican horror stories have been debunked whenever the facts have been examined. There are no death panels, and the Republican predictions of doctors refusing to see Obamacare patients or long waits have turned out to be false. Health insurance companies desire to increase participation in the exchanges, and premium increases are projected to be far less than Republicans have predicted. However, despite the success, the debate over Obamacare is unlikely to end soon. Far too many Republicans suffer from Obamacare Derangement Syndrome.

This includes a degree of short term memory loss. The individual mandate, selling insurance through exchanges, and high deductible plans to discourage spending are all conservative ideas which most Republicans supported up until the Affordable Care Act was nearing passage in Congress. This year Republicans will continue the attacks on Obamacare because of the intensity of opposition among Republican voters. Elections, especially off-year elections, have become far more about motivating the base to get out to vote as opposed to convincing undecided people to vote for your party. Repeating the same lies about the Affordable Care Act will motivate their voters to get out to vote. If Democrats, who at times are almost as inept at campaigning as Republicans are at governing (and predicting the effects of Obamacare), continue to cower in fear over their own accomplishments, there will be little to motivate as many Democrats to get out and vote.

However the realities will change over time, as First Read explained:

It’s easy to explain why the GOP doesn’t want to move on. Health care is the issue that fires up the base; it unites a party that’s divided on other issues; and the law remains mostly unpopular in most public-opinion polls. Obama even recognized this when he talked about possible bipartisan fixes to the health-care law during his news conference yesterday. “My suspicion is that probably will not happen until after November, because it seems as if this is the primary agenda item in the Republican political platform.”

That’s a short-term winner but a long-term problem

That political platform looks like a short-term winner in the upcoming midterm elections, with the GOP having an excellent opportunity of winning back the Senate. But it raises other long-term challenges. What do you do with the eight million Americans who now have insurance on the exchanges, and with the 24 million Americans who are projected to be on the exchanges by 2017 (the next time there’s the possibility of a GOP president)? What about the millions more who have insurance via expanded Medicaid or via their parents’ insurance? And how do you advocate repeal and replace when you don’t have a detailed legislative alternative (that’s scored by the Congressional Budget Office)? Come 2015 and 2016, Republican presidential candidates could very well find themselves in an unsustainable position — having to campaign on a repeal message in the primaries (because that’s what GOP voters want), but then having to face a general electorate that’s more hostile to the idea (because repeal doesn’t poll well outside the GOP).

Americans will not want to repeal Obamacare when they consider what this means. We cannot take away health insurance from millions, and place many more at risk of losing coverage should they become sick. In the near future, to argue to repeal Obamacare will sound as absurd as arguing to repeal Medicare. Of course those who think that Republicans have really moved beyond wanting to repeal Medicare haven’t paid enough attention to the Ryan budget which Republicans have repeatedly voted to support.

Cross posted from Liberal Values