Obamacare: Democrats' Stealth Weapon in 2014


With the beginning of a new year, President Obama has turned his focus on the central values battle that won him two elections: his progressive economic vision. The President has been pitch perfect in taking command of the economic agenda and the advocacy for upward mobility. Want proof? Watch the Republicans falling over themselves trying to establish themselves as advocates for the poor - with really terrible, bad, policy ideas, but they are trying to get ahead of it.

The Republican message on poverty is old, broken, and divided between themselves to boot. Prominent Republicans are torn between such bold ideas as turning over the federal money to the same states that won't help poor people by expanding Medicaid at 100% federal expense, robbing public schools of public resources, etc. But if that doesn't work, they are also prepared to declare the war on poverty a failure, and move on to their preferred war, the war on the poor.

Clearly, coming up with solution to economic stagnation and poverty is not a right wing strong suit. In fact, it can be said that addressing the issues of economic inequality, poverty, and opportunity is the right's weakest foot. And you don't start an election year on your weak foot if you have another choice.

As the Republicans scurry to get their message together on the issue of economic inequality, poverty and and opportunity, the pundit class has ignored one crucial issue aiding the president's case and destroying the GOP's: Obamacare. Health care reform is not just a health care issue - it is an economic issue. Now that Republicans can't conveniently beat the drums of a bad website anymore, Obamacare is likely to take a crucial role in the debate, but not in a front-and-center way.

Firstly, and most directly, Republicans will have a tough time defending their governors and state legislatures for turning down 100% federal dollars to provide Medicaid coverage to working adults living in poverty. These Republican governors and legislatures are literally denying coverage to their residents because they are too poor, and for a party trying to recreate a "compassionate" conservative image, there simply is no excuse.

Secondly, Republican campaigns to repeal it will take on a new meaning: it will no longer be an attempt to get rid of "government control of healthcare" but actually taking away affordable, quality health insurance from millions of Americans who have already gained it because of the ACA, and millions more who continue to gain it.

Which brings us to the most critical role of Obamacare in the debate over poverty and economic security. Before the ACA, health insurance wasn't just a benefit tied to employment, it was an economic shackle for those who were lucky enough to have a job that provided it and an economic disaster waiting to happen for those who did not. That ends now. Insurance companies are no longer allowed to treat individual policyholders as ATM machines up until the point they actually need the health insurance, and employers are no longer allowed to hold the possibility of losing health insurance as leverage against their employees stuck in dead end jobs.

But universal access to affordable health insurance regardless of employment status or income isn't just good for employment and economic mobility. Early studies are already finding that having access to affordable, quality health care and insurance drastically reduces other economic burdens that fall most heavily on the poor - having to choose between paying health care bills and other bills, having to go without medicine or without food, and worst of all, having to declare bankruptcy because of medical costs.

Not only do medical costs themselves drive small businesses out of the market in favor of their bigger counterparts and wreck havoc by themselves on family finances, problems the ACA is beginning to solve, the side-effects of those expenses also affect the poor in the worst ways. If medical bills are preventing someone from paying their other bills, or their rent, their credit is ruined simply because they got sick or they got into an accident. Bad credit leads to inability to get loans - whether on a car, a home, or any big purchase - and even when someone with poor credit can get a loan, high interest rates ensure high monthly payments, in turn leading to smaller and smaller disposable income, locking individuals and families into the cycle of poverty forever - simply because they, or a loved one, fell ill.

Of the factors that drag people to poverty and then keep them trapped there, medical cost and health issues are among the most stark.

As this burden lifts from the American people under Obamacare, Americans will be more free to take a new job and start a new business, and businesses will free up excess money going to health care to invest and innovate. And when you tell them you want to take that away from them, they are not going to like that very much.

The conversation about poverty is a conversation about economic opportunity and even more importantly, economic security. The Affordable Care Act is already becoming an integral part of that security. This is why Republicans are suddenly no longer talking about how Obamacare is costing jobs - because if they do, they will be talking directly to 9 million people who now have coverage because of Obamacare (and millions more who have better coverage and more security). This is why their talking points on the poor are avoiding the central health care issue for the poor: Medicaid.

Health care security IS economic security. The president has an upper hand on the issue of economic security not simply because he has the better ideas on it, but because despite all the corporate, right wing and media shenanigans, he has delivered on that crucial part of economic security. Because he delivered on health care security, Republicans can no longer scare people against a minimum wage increase by telling them that they might lose their health care if their employer had to pay them a living wage. Because the president delivered on health security while reducing the deficit, the Right's pleading that unemployment benefits are just "spending" gets laughed at.

So no, Obamacare itself won't be a big, explicit part of the debate on poverty and economic security. But like Medicare and Social Security, it will form a basic social contract that is taken for granted as we have that conversation. Just as Social Security benefits have become a basic floor (rather than a bargaining chip) in economic security for seniors, so is Obamacare quickly raising that floor for all Americans' economic security. Obamacare will not be significant because it consumes the debate, but because forms a big part of the American social compact that will serve as the baseline for that debate.