Published on November 30th, 2013


Chris Ladd: What Comes After Obamacare

The GOP has embarked on yet another desperate push to persuade the public that the Affordable Care Act is too flawed to tolerate. The far right might win this ill-conceived campaign but they may be very, very disappointed when they see their prize.

The core problem behind the GOP’s Obamacare gambit is we still have no alternative to offer. As a consequence, winning this campaign would probably be worse than losing. What comes after Obamacare? At this point the most likely answer is some form of single-payer insurance.

Through the cloud of hype and lies that has obscured the rollout of, one fact has emerged which should be giving Republicans pause. Expanded Medicaid enrollments under the ACA are rolling along smoothly. The Federal government, which according to Republican conventional wisdom cannot manage healthcare, is signing up new Medicaid recipients at a breakneck pace without a hitch.

Which part of the ACA is failing so far? The one involving private health insurers.

Without some alternative plan to offer, the GOP will be in no position to gain from Obama’s troubles. Rock-throwing is not policy. The bubble-dwellers have missed out on one crucial fact about public-opinion on Obamacare. A large component of the public opposition to the ACA is based on the fact that it fails to provide a publicly funded insurance program available to everyone.

Oh, and by the way, the process of enrolling new Medicaid recipients is rolling along swimmingly. Did I mention that?

Of all the complaints about the ACA, the one with the most traction in the real world is the fact that many middle earners who were previously paying for their own insurance will now pay more. They will pay more because the lousy policies they had been carrying have been legislated out of existence, they do not qualify for lower-income subsidies, and because they live in states that are resisting the provisions of the law that might otherwise have helped them buy better insurance.

For all the hype about the broken “you can keep your insurance” promise, that line won’t take us very far. Those affected are not a pool of people who loved their insurance options in the pre-Obamacare world. They were suffering some of the worst conditions created by our pre-ACA system.

They may be troubled by receiving cancellation notices, but those notices are not a new phenomenon and for most them their insurance already sucked. A small number of insurance cancellations are hardly going to convince people to return to a scheme under which your insurance could be cancelled because you got sick. If given an option to support single payer insurance or a useless package of Republican tax cuts, which direction is the public most likely to go?

Death Panel politics is short-term politics. The current Republican smokescreen of lies and distortions will have blown away before the mid-terms, much less 2016. What will be left is a country still living under a hopelessly complex, patched-together solution which only extends coverage for a subset of the uninsured. If Republicans expect to gain any credibility, we have to counter with more than whining. We need a plan.

There are a lot of options that could gain public support, but one thing is now crystal clear: whatever program eventually takes the place of the ACA, it will provide affordable insurance coverage for everyone, regardless of income. If Republicans want to present such an option, we will have a solid chance to participate in the debate that’s likely to come. If we don’t devise a plan, then the failure of Obamacare will most likely lead to some version of single payer insurance. It’s as simple as that.

If Republicans are not ready to present America with a proposal to deliver quality health insurance to everyone regardless of income, then it would be wise to shut the hell up about Obamacare. Until we have a plan, not just a slogan, the only people who will benefit from the failure of the ACA are in the progressive wing of the Democratic Party. At this point, the failure of the Affordable Care Act would take America to a place we do not want to go. When the history is finally written, the Tea Party may find that all they gave America was single payer health care and a lingering hangover.


Chris Ladd is a Texan who is now living in the Chicago area.  He is the founder of Building a Better GOP and has served for several years as a Republican Precinct Committeeman in DuPage County, IL, and was active in state and local Republican campaigns in Texas for many years.  He blogs over at (Email: chrladd AT gmail DOT com)

 Read Chris’s shiny new GOPLifer blog. It still has that new blog smell!

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One Response to Chris Ladd: What Comes After Obamacare

  1. Darnell says:

    It is evident that the author don’t believe in the principles of free market

    The ACA will lead to single payer government plan anyway. That is the main goal of the ACA. The bottom line is that the ACA is UNAFFORDABLE and hurt jobs in the private sector.

    The free market must be allowed to work. It is not a quick fix to health insurance.

    As far as the spike in medicaid enrollment. That was expected. If the federal government would get out of the way and let the States reform medicaid as needed, practically everyone who need coverage would get it.

    Example: Medicaid should be reform to allow people with pre-existing conditions and uninsured to purchase coverage with a monthly premium based on income……(say no more than $20 per month.)

    The ACA with the Independent Medical Advisory Board will lead to RATIONING OF CARE. It is just a matter of time. A country with over 300 million people cannot depend on government for health care.
    The free market is the best route for affordable coverage.

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