The Republican Health Care Problem

Yesterday's historic Supreme Court decision to uphold President Obama's health care legislation caught many pundits and politicians by surprise. Often thought of as the likeliest swing vote, Justice Anthony Kennedy sided with the dissenting minority. Meanwhile, Chief Justice John Roberts, a George W. Bush appointee who delighted conservatives when he was nominated, voted to uphold the law.

This court decision obviously disappointed and disheartened Republican voters and politicians. But the real fallout with this verdict lies not with the Supreme Court's actions, but rather with how Republicans stand to further discredit themselves in their responses to the upholding of what they derisively call "Obamacare."

First, there is some obvious damage that has been done to the Republican Party's credibility. Many Republicans criticized the Affordable Care Act ("Obamacare") as "unconstitutional." They also claimed that the unconstitutionality of this law was even more ironic since it was advocated by President Obama, a "constitutional law professor." (The mocking of Obama as a "constitutional law professor" is akin to mocking him as a "community organizer.") Obviously, since the law was upheld, it renders both of these criticisms moot. The "constitutional law professor" supported a law that was found "constitutional." At the very minimum, that enhances Obama's credibility at Republicans' expense.

More importantly, however, is how Republicans are responding to the Court's decision. Mitt Romney announced that he would repeal Obamacare if he were elected president. Congressional Republicans have also scheduled a vote on a full repeal of Obamacare in mid-July. These decisions are unwise for several reasons:

1. After criticizing Obama for pursuing health care reform at the expense of not paying enough attention to the economy, Republicans could come across as being guilty of the same negligence they accused Obama of showing. Obama will likely and wisely pivot to handling economic affairs, such as tax credits, incentives or infrastructure investments to spur job creation. Even if nothing actually gets accomplished on this front, Obama could claim that he is trying to "put people back to work" while Republicans are "stuck relitigating the past." And since Romney's strongest card this election cycle is the economy, does he really want to make health care reform his top focus on the campaign trail?

2. Obama and congressional Democrats have a plan regarding health care reform. Republicans have nothing to offer on this front except opposition. There is little specificity when it comes to Republicans' health care reform ideas. They commonly say something along the lines of "repeal Obamacare" and put in place "common-sense solutions." What are these "common-sense solutions?" Romney in particular is boxed in on this issue because the very elements he complains about in Obamacare are similar to what he signed into law in Massachusetts. As for congressional Republicans, they should remember that even though Obamacare as a whole and the individual mandate may not be wildly popular with the electorate, the individual provisions of the law are. Do Republicans really want to campaign on repealing provisions that the public likes, especially if they have nothing better (or nothing at all) to offer as a replacement?

3. Republicans will have to get honest with themselves regarding taxation. Chief Justice Roberts may have given Republicans a political opening by asserting that the "penalty" levied against adults without health insurance fell under Congress's authority to tax. Claiming that Obamacare raises taxes is easy politically. But if Republicans wish to repeal Obamacare and replace it with their own legislation (they can't just repeal Obamacare and have the health care system revert to the chaos it used to be), how can they drive the cost of health care down and increase the ranks of the insured in a revenue neutral way? Medicare and Medicaid are among the biggest contributors to the national debt. More people are living longer and seeking increasingly expensive medical treatments. If Republicans do not wish to raise taxes or cut spending on Medicare and defense spending, what all is left? There is not enough money in low-hanging fruit like the National Endowment for the Arts or the Department of Education to offset the costs of Medicare and health care in general.

There is a simple question that journalists should ask anti-tax Republicans: "How low should taxes be for you to no longer seek to reduce them?" Journalists have been derelict in seeking clarity from Republicans on just how low taxes have to be in order for them to stop complaining that taxes are too high or that there are too many taxes in general. It seems that for Republicans, all taxes are bad and all taxes should be lowered. But taxes are necessary in order for a civilized society to operate. Taxes support the American military, food safety inspectors, baggage screeners at airports, embassy officials, and law enforcement personnel. At some point, Republican rhetoric on cutting taxes is going to conflict with the reality of public policy and the math associated with it. That will undermine their branding as the party of "fiscal responsibility." (Note: Democrats are obviously also guilty of not being honest about the need to reduce spending on some government programs, but regarding health care, they at least sought ways to pay for it by taxing people who don't purchase health insurance or taxing high-end insurance plans.)

4. Obama and congressional Democrats have the chance to appear magnanimous while Republicans risk looking partisan and vindictive. Obama announced in his White House statement yesterday that he was willing to find ways to improve the health care law. He also said he wanted to move on. The more Republicans complain about repealing the health care law (instead of modifying it to make it more palatable), the more they may seem too consumed with getting even with Obama or punishing him politically. Now that the Supreme Court has settled the constitutionality of the law, the public might be more inclined to move on. The July 11 repeal vote in the House of Representatives next month has no chance of passing both houses of Congress, so it looks like Republicans are playing a partisan political game and wasting time. While conservatives and critics of Obamacare might not be content with this decision, it would seem that independents who want Congress to get things done would recoil at the thought of yet another fight over something that was debated for over a year and settled by a Supreme Court with a conservative majority.

This is not to say that Obamacare is without its faults. However, Republican resentment of Obama and their fealty to their antitax base may cause the GOP an even greater headache down the road than the one the Supreme Court gave them this week.