The race is on to persuade Americans that Obamacare is either the worst idea since Prohibition or the best idea since Social Security or Medicare.
A great public relations war is now underway. Republicans are widely perceived to have lost Round One when they shut down the federal government, hurt the economy and got nothing in return for their antics. President Obama and the Democrats clearly lost Round Two when they acknowledged that the Obamacare rollout was a disaster, the website didn't work and Obama was forced to admit he misled the American people when he said everyone who liked their current insurance plan would be able to keep it.
Expect several more PR rounds, perhaps one a month, through the 2014 election, when the voters will render a verdict on Obamacare, possibly by turning the Congress over to one party, instead of the current stalemate of divided government.
Or the stalemate could continue until the 2016 election.
So, who are the winners and losers under Obamacare? It depends on who's doing the calculations, but in general about 12 million people are likely to be better off, and somewhat fewer than four million people, if they don't currently have insurance, could be worse off. But the four million (or less) who are likely to be worse off financially could be more vocal and politically powerful than the 12 million who are likely to be better off. Discontent causes anger and tends to spur political action, while contentment may simply cause complacency and passivity, rather than gratitude and a desire to reward the political party that improved your status.
Obama's temporary fix -- allowing insurance companies to keep consumers on substandard plans for another year -- might reduce the four million even further.
The New York Times pointed out that between 12 and 14 million Americans are clear winners from Obamacare. An estimated seven million generally low-income Americans can get coverage without paying any premiums at all. Another five to seven million people will qualify for subsidies that will pay most of the cost of comprehensive plans.
But an estimated four million individuals -- generally independent contractors, small businessmen, or freelancers who do not have employer-based insurance -- individuals who make more than $46,000 a year, or families that make more than $95,000 a year may lose financially from Obamacare. They may be required to pay more for new policies -- up to eight percent of their income. These policies should offer more comprehensive coverage, but will cost more. Surely some of the four million citizens will be satisfied to find more comprehensive insurance, even if it costs more. But probably a majority of the four million will not be happy, and could even be outraged.
A strong argument could be made that most of those people are middle-class free-loaders. By refusing to buy insurance, even though they can probably afford it, they're expecting the rest of us to pay for their care if they get sick while uninsured.
With the new individual mandate, citizens must purchase insurance or face a tax penalty or fine of up to eight percent of income. (If you can't find a health insurance policy for less than eight percent of your income, you're exempt from the penalty.)
There will be complaints from some small businesseses (with 50 or more employees) that they could hire more people in 2015 if they didn't have to pay employees' health insurance or pay the $2,000 to $3,000 penalty per worker for not providing it.
There may also be complaints from people working part-time that they would be working full-time if the government didn't require companies to pay for health insurance.
Economists are divided about Obamacare's impact on employment:
- ObamaCare Will Drive Up Unemployment and Health Care Costs (Forbes.com)
- Employers Plan to Hire More Full-Time Workers As Obamacare Rolls Out (ThinkProgress)
If unemployment rises or does not decline below 7.2% between now and 2016, this issue could indeed hurt Democrats.
If unemployment declines to six percent or lower in 2014, the issue could hurt those Republicans who voted to shut down the government and classified Obamacare as a disaster when it actually helped far more of their constituents than it hurt.
Time will tell.