When the Supreme Court landed its latest, and possibly last, legal defeat to right-wing opponents of Obamacare, the immediate response on the right was, oddly enough, to mock the liberals who warned that the lawsuit might succeed. Conservative lawyers circulated lists of liberals who predicted that Amy Coney Barrett would side with the plaintiffs; National Review turned that list into its lead story. “They lied, lied, lied,” cries Senator Charles Grassley.
I never believed the most recent lawsuit stood much of a chance. The court’s conservatives, after some wavering, decided the first lawsuit intended to destroy Obamacare was too silly to risk their reputational capital on. The second, even sillier lawsuit lost by a wider margin. It stood to reason that the third lawsuit, the silliest one yet, would probably lose, even though conservatives had gained an additional seat.
It is probably fair to mock hand-wringing liberals for being so apocalyptically pessimistic that they thought five Supreme Court justices would side with an utterly farcical lawsuit. But perhaps this is not the only, or the most important, implication of the ruling.
If the suit was so absurd that liberals deserve ridicule for thinking it stood any chance of success even in a right-wing court, what does it tell us that Samuel Alito and Neil Gorsuch voted for the plaintiffs? For that matter, what are we to make of the fact that the Trump administration’s Justice Department, joined by the attorneys general for 20 states, signed on to this laughably flimsy case?
The answer is that the passage of Obamacare was a traumatic event for Republicans. The wound it opened in the party’s psyche has not fully healed, and even more than a decade after its passage into law, they cannot reconcile themselves to its legitimacy.
The passage of Obamacare, even though it merely incrementally expanded an existing program (Medicaid) and copied a program designed by a Republican governor (Mitt Romney) was met by unmitigated hysteria on the right. What seemed to unhinge conservatives was less the substance of the bill than the very idea of Democrats using their control of government to … govern. Republicans became fixated with the sinister machinations that they believed had produced the bill.
They attacked “backroom deals,” which is of course a description for every deal ever made in Washington. They threw a fit at the use of budget-reconciliation procedures to iron out minor differences between the House version and the Senate version, the latter of which had attracted 60 votes. At one point, the proposed use of an obscure maneuver called “deem and pass” inspired conservative media to call the process “demon pass,” a symbolic expression of their belief that the legislation was demonic.
A little while ago, the conservative writer David French observed that many of his neighbors in his community in Tennessee still believe that Obamacare had done terrible things to their lives, despite having no clear sense of what these horrors were.
This belief was an outgrowth of conservative media’s refusal to discuss the actual contents of the law, which were overwhelmingly popular. It regulated the individual insurance market, so that insurers could not price people with preexisting conditions out of the market, and taxed the rich to finance subsidies to make coverage affordable for those with low incomes.
Turning a policy question over insurance-market regulation and subsidy levels into a cultural fight was a shrewd, and perhaps necessary strategy. But it left the party’s elite with no way to back down. Having persuaded their own voters the law was evil and an existential threat, they had to act as if this claim was true. Hence red states refusing to opt into the Medicaid expansion, even at the cost of punishing their own doctors and hospitals, who have been stuck with the cost of treating uninsured people who show up in the emergency room. (Their lack of concern with the actual physical and financial well-being of their poor citizens, alas, merely reflects a longstanding preference.)
For a lawyer in a Republican state, refusing to join a lawsuit to eliminate Obamacare merely because its legal merits were preposterous was therefore unthinkable. If they had ambitions to a future court nomination, how could they dare mark themselves as ideologically unreliable by opposing the holy cause of Obamacare repeal, in any form? If they had political ambitions, how could they expose themself to a devastating attack ad — friend of Obamacare! — in a future Republican primary?
The pattern of the anti-Obamacare crusade has continued to define the Republican party elite’s relationship with its base. First, they make a practical decision on the basis of self-interest, then convince their voters the cause is existential, then discover they have no choice but to act as if their own lies are true. So it was with repealing Obamacare, and so it is with supporting Donald Trump. More than a decade after the law was passed, the party still has not freed itself from its own lies. When you calculate how long Trump will own them, ponder that.