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The Plot to Kill Obamacare

Illustration by Kristian Hammerstad  

Those few conservative intellectuals who seek to nudge the party toward the center on economics dance carefully around the Obamacare taboo. Ross Douthat urges Republicans to adopt other kinds of health-care reform to replace Obamacare but has never expressed an opinion as to whether Obama’s law actually improves upon the status quo—which, after all, is the only political choice that has come before Congress over the past three years. AEI’s James Pethokoukis, another reformist conservative, wrote a recent column that implicitly floated the heretical notion that the health exchanges might not fail; he carefully prefaced his argument with, “First a perfunctory ‘Obamacare delenda est.’ ”

The dominant intellectual figure within these restrictive intellectual confines is Yuval Levin, a Bush-­administration health-policy staffer, editor of National Affairs, frequent contributor to both National Review and the Weekly Standard, adviser to Paul Ryan, and a 2013 winner of the Bradley Prize, a $250,000 grant to conservative pundits. Among his conservative peers, Levin is best able to produce a ­credible-looking facsimile of social-­science methods, a skill for which he is regarded with a kind of awe on the right. (Levin, as the libertarian blogger Megan McArdle gushes, is “an ultrawonk who appears to have had the entire text of the PPACA tattooed on the inside of his eyelids for quick reference.”)

Through his channels of influence, Levin has beat the drum for repeal, relentlessly pounding home a narrative in which Obamacare is flailing and collapsing at every turn. The details of Levin’s indictment change and often contradict each other. As recently as March, he was insisting that health-care costs had only slowed because of the recession, taunting liberals for their “very implausible expectation” that the slowdown might continue and declaring that Obamacare would make costs grow faster. He has more recently taken up the line that the cost slowdown started years before and has nothing to do with Obamacare, neglecting to mention his insistence that Obamacare made any such slowdown impossible. The details of Levin’s indictment matter less than the fact that there are details at all. The bottom line never changes: Obamacare is a “disaster,” a “monstrosity,” a “calamity,” the “catastrophe is a function of the law’s very design,” and on and on.

The contrast between the cautiousness of mainstream health-policy analysts and the perfervid certainty of those on the right reprises what has become a common pattern in American political debate. Remember this time last fall, when pollsters, political scientists, and analysts like Nate Silver read the campaign data and guardedly declared Barack Obama the presidential front-runner, while a coterie of self-styled conservative public-opinion analysts and their allies crafted a counternarrative in which Mitt Romney was marching toward victory? That asymmetry of confidence lent the Republican arguments a vigor that masked their vaporousness. The imbalance fed upon itself. Conservatives assumed that the cautious evenhandedness of liberal analysts must signal some deeper uncertainty, which in turn made them bolder still. Ultimately, most political reporters got suckered into taking the contrived Romney-momentum story seriously.

To an even greater extent, the right has dominated the Obamacare public debate through blunt rhetorical force. Conservatives regard the law’s disintegration not as a probability or even a certainty but as something that is already occurring. Obamacare is a “broken, failed experiment,” declares Marco Rubio. “You’re now seeing the public collapse of Obamacare,” announces the Weekly ­Standard’s Stephen Hayes. “Every morning brings fresh news of terror: missing deadlines, programs running out of money, premiums set to soar, flailing technical implementation,” observes Wall Street Journal columnist Kimberley Strassel.

And it’s true: People who follow the progress of Obamacare through Fox News, the Drudge Report, and conservative talk radio have indeed witnessed an endless litany of incompetence, corruption, and clumsy bureaucratic attempts to hide the socialist horrors in store for America. The conservative Obamacare narrative has blown up small administrative glitches into epic bungling and utterly ignored the most important markers of progress. The crowning episode in this narrative was a hearing of the Senate Finance Committee last April, in which the chairman, Max Baucus, grilled Secretary of Health and Human Services Kathleen Sebelius. Baucus, a major author of Obamacare, expressed his fear that the administration had stripped out too much funding to publicize the law, leaving consumers without enough reliable information about how to participate. Conservatives seized on one of the characterizations Baucus used—“train wreck”—and turned it into the law’s defining catchphrase, just as “I am not a crook” was Richard Nixon’s. It was the juiciest slipup, the most telling admission—if even the law’s author admitted it would collapse, imagine how bad it must really be! In fact, Baucus was complaining not about the law’s design but about its meager advertising budget. But by the next month, the talking point had embedded itself so deeply that even such figures as Charlie Rose were asking, “Does everybody, in the words of Max Baucus, consider this a train wreck?”