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A.B. Stoddard: ObamaCare must change

Reaching more than 7 million new enrollments in an unpopular healthcare program, using a still breaking website, is indeed a formidable accomplishment for the Affordable Care Act (ACA). And in touting the positive development Tuesday, President Obama was correct in describing new access to healthcare as “progress,” stating that Armageddon had not arrived and declaring that the debate over repealing ObamaCare has ended. But until Democrats work with Republicans to change it, the ACA will remain their worst political liability and could ultimately become their worst regret.

Four years after a partisan process produced ObamaCare, the program is more political than ever: A new Gallup poll shows support for the ACA is dependent on party affiliation, with Republicans 17 times more like to disapprove than Democrats. Even worse for Democrats is that independent voters are five times more likely to disapprove as well.

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No matter the polls, the ACA is a permanent new entitlement no party can take away. In an acknowledgment of that reality, House Speaker John Boehner (R-Ohio) responded to the enrollment news — noting his own premiums have doubled and his co-pays have tripled — by stating that his conference is searching for consensus on how to replace the ACA. Louisiana Gov. Bobby Jindal, a 2016 presidential hopeful, also just declared his own plans to replace ObamaCare, urging Republicans to “cut and paste from it.”

The president’s political advisers have made clear that now that open enrollment has ended, they want the subject changed. Obama plans to talk up income inequality and the need to increase the minimum wage. But, as the president promised “there will be additional challenges to implementing this law,” he should consider promising changes as well, in time to save his Democratic majority in the Senate. 

Obama knows that, should the GOP win a majority in both houses of Congress, or even if Democrats hold a slim majority in the Senate next year, Democrats will move to reform the ACA, and that Hillary Clinton — or any Democratic 2016 candidate — will as well. Why not push for it now?

So far, the administration has made it a practice to only release appealing enrollment data, like the number of new people covered in the exchanges. Though we know it took $52 million in paid media from January through March alone to attract enrollees, we still don’t know how many have paid; how many are in Medicaid; how many are low-risk, healthy patients; and how many are newly insured after losing their original plans. We don’t know how many will make a first payment only to drop off later, how many people have lost their doctor, or how many are now paying more for coverage. Those people might be enrolled — and telling everyone they know, like Boehner, how displeased they are. Time will tell all of that, if not in accurate enrollment data released by the administration with the transparency Obama has promised, then at the ballot box.

Obama is likely hoping, as he always does, that time will change minds. He hopes months or years will bring more coverage to the uninsured, strengthen the ACA and ultimately convince critics the system is not only sustainable but affordable. But in the near term, as long as Republicans and independents can’t stand ObamaCare, Democrats will lose red states, and possibly purple ones, too. If they lose power, they will undoubtedly blame it on ObamaCare.

Convincing Republicans of the law’s merits is far more difficult than working with them to change it. Encouraging Democrats to try and fix ObamaCare now could mean Democrats keeping the Senate instead of losing it. In the long run, Obama’s only hope is change.

Stoddard is an associate editor of The Hill.