Is Obamacare a Republican Job Creator?

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Almost 50 years ago, Congress passed and Lyndon B. Johnson signed the law establishing Medicare. It was, soon, wildly popular—so much so that to this day Republican opposition to the program can only be expressed in terms of  “saving” Medicare from supposed instability.

In the next congressional elections, liberals took a beating—and the Democrats lost the White House in 1968. Scratch that—Democrats lost five of the next six presidential elections.

That’s not the only story I could tell like that. Social Security? It passed in 1935, during what turned out to be a very good election cycle for the Democrats. Implementation began after the 1936 election, and the 1938 election began a string of conservative coalition control in Congress that lasted 20 years.

Want another one? Let’s try foreign policy. The Cold War was over time a bipartisan policy, but it was the Republicans who were in office when the Cold War ended and the Soviet Union dissolved … a policy outcome universally applauded and most certainly associated with the party of Ronald Reagan and George H.W. Bush. Since then, Republicans have only won the national vote in one out of the last six presidential elections.

All of which is to say that the relationship between policy outcomes and electoral history is complicated at best.

Which gets us to the future of the Affordable Care Act. Recently, I made what’s ultimately a narrow argument about how health-care reform would be popular, even if “Obamacare” remained unpopular (see Ezra Klein, who made the case as well). But there’s also a broader question here, one that’s basically at the core of the Republican obsession with the “47 percent.” It’s that, as Steve Benen puts it, “Obamacare will provide a whole new meal of socialist treats seducing Americans into socialist dependence.” What’s more, the accusation—explicit at times, implicit at others—is that the only reason Democrats support such programs is that they deliberately want to “hook” the majority of U.S. voters on these programs and, as a result, secure permanent electoral majorities.

I can see the appeal of the theory. For those who oppose universal health care (and universal retirement programs, and the minimum wage, and indeed all anti-poverty programs) but still want to think of themselves as compassionate Good Guys, a theory that government is merely a cynical ploy to win votes would be a very comforting belief.

There is, however, one problem: It’s utterly, completely, totally wrong.

Voting doesn’t work like that.

Indeed, the main conservative story about all of this is nonsensical. If it were true that bigger government produced helplessly dependent Democratic voters, the two decades after 1966 should have been a wonderful era for those Democratic politicians. That didn’t happen.

Granted, conservatives can move goalposts around however they want, always convinced that the next expansion of the welfare state is the one that forces just enough of us into dependency that the prediction of a permanent socialist/Democratic majority comes true. Except it’s all nonsense. Large majorities of voters have been “dependent” on government ever since (at least) the New Deal. Not only because of Social Security (which, remember, provides security not only for those who have retired but perhaps more critically for their children who no longer have the burden of supporting them unaided) but because from that point on, government intervention has been the stated policy of all administrations. The bottom line: If the conservative theory about dependence is true, the Reagan revolution or the Gingrich revolution or the Tea Party revolution could never have happened. Let alone the Thatcher revolution, which happened in a far more “dependent” society.

It’s not just about elections, either. Public-opinion data going back decades indicates that voters tend to react to the ideology of the party in government by shifting the opposite direction. As George Washington University public-opinion scholar John Sides says:

[T]he public is simply a thermostat. When government spending and activism increases, the public says “too hot” and demands less. When spending and activism decreases, the public says “too cold” demands more.

If that’s true, then the story conservatives tell themselves is completely backward! The Affordable Care Act will tend to make voters more conservative even if it is successful.

That makes a certain amount of sense. In 2008, anyone unhappy with their current health insurance could consider two options. One, supported by conservatives, was (in effect) the status quo; liberals supported change. Unhappy? You must be a liberal. But once Obamacare is fully implemented, it will be the liberals who (more or less) support the status quo. Again, if you’re unhappy about health insurance in 2014 or 2015 or 2016, then that logically (again, more or less) implies that you must be a conservative.

Or, to put it at another way: Suppose that liberals are right that there are potential benefits from collective action through government, but conservatives are also correct that government intervention does have some dangers and drawbacks. If that’s the case, then we should expect more people to be aware of and concerned about the dangers of overreach exactly when government has expanded. Even if the expansion is mostly successful.  

It is true that if the Affordable Care Act works that people will want to keep the benefits they enjoy from the program. But that’s nothing new—people wanted those benefits back in 2008, too; that’s (among other reasons) why Democrats have run on universal health care for decades. It’s very popular! Or at least it was, before it passed. Gallup, for example, found strong majorities who believed that “it is the responsibility of the federal government to make sure all Americans have health care coverage” every time they asked from 2000 through 2008.

Indeed, one way to look at the Obamacare/ACA split is that passing a new program with a long lag time before implementation may expose the split between wanting benefits and fearing overreach. To simplify: Perhaps the natural evolution of liberal expansion of government is that programs are popular in the abstract when they don’t exist at all; they are less popular as they take real form and people worry about (or perhaps experience) overreach, but eventually if they are successful they become part of the normal status quo. None of which makes voters either more liberal or more conservative. “Obamacare” and the ACA allow separate outlets for both; “Obamacare” inspires the popular imagination into fits of bemoaning “government takeover” and “death panels,” while the ACA quietly goes into effect and provides benefits that will rapidly become uncontroversial.

That last bit was speculative. But what’s not speculative at all is that the theory of socialist dependence is garbage. Yes, a lot of government benefits are popular—but they’re just as likely to be popular, and perhaps even more likely to have electoral effects, before they’re passed. Not after. And the partisan effects of all of that are unpredictable. The idea that once Obamacare is implemented voters will inevitably become hopeless wards of the state and of the Democratic Party may make some ACA opponents feel good. It just doesn’t square with anything we know about elections and public opinion.

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