Politics Ted Cruz's Worst Nightmare Is Coming True Obamacare is working.

Richard Kirsch is a senior fellow at the Roosevelt Institute and a senior advisor to USAction, a grassroots organization that advocates for affordable health care, among other things.

Last August, as conservatives barnstormed the country seeking to build support for a cockamamie plan to shut down the U.S. federal government unless Congress voted to repeal the Affordable Care Act, Ted Cruz, the Texas Republican senator, said something surprisingly prescient about the president’s signature health-care law.

“President Obama wants to get as many Americans addicted to the subsidies because he knows that in modern times, no major entitlement has ever been implemented and then unwound,” he said. The worry, according to Cruz, was that once the ACA went into effect, we’d all be “addicted to the sugar.” Then, it would be too late to roll it back.


Cruz’s nightmare, and the left’s long-held dream, has come true. Finally, after years of failed reform efforts, the U.S. government is actually trying to provide affordable health coverage for all. And it’s working, despite Republicans’ relentless attempts to deep-six the law. As a result, the politics of Obamacare will never be the same.

The right’s biggest fear was never really, as Cruz’s comments revealed, that Obamacare wouldn’t succeed. It was that it would.

Americans, it turns out, have a compelling desire for a basic necessity of life: affordable health coverage. That’s why, despite the HealthCare.gov debacle, and campaigns in red states to discourage enrollment and defund outreach efforts, eight million Americans signed up. Young people ignored tasteless ads and anti-Obamacare campus beer parties, funded by the Koch brothers, to enroll at strong enough rates. Millions more enrolled in Medicaid, even in states that did not expand the program, as awareness of coverage options increased. There is even a big upswing in take-up of employer coverage, despite GOP claims that Obamacare would destroy the employer-based system. The Congressional Budget Office just lowered its estimate of the law’s costs, and overall health-care inflation is at historic lows. It’s been a tough few weeks for the Obamacare-bashers.

In fact, the law’s success reverses the political calculus: Those who advocate repeal can be rightly accused of taking away health coverage from some 15 million Americans. Although some of these are low-income people, less likely to vote, many others are middle-income people who are surprised and relieved at having access to good, affordable health coverage – including, by the way, a lot of Republicans.

My favorite ACA success story is of an Ohio Republican woman profiled in Time. Republicans could say she was forced to cancel her coverage and is now paying more. But the real story is that her canceled coverage did not pay for the life-saving cancer care her husband needed. Overcoming “a lot of talk that this is a bad law,” she enrolled through HealthCare.gov and is paying a little more now for health coverage that is actually covering her husband’s cancer care. She went from “I don’t want anything to do with it [Obamacare]” to saying it is “a godsend.”

Recent polling shows that support for repeal is shrinking to the most conservative voters, key to Republican primaries but not enough to win most statewide general elections. When given a choice of whether to repeal the ACA or keep it intact or with small modifications, a recent Bloomberg poll found, only a third of Americans (34 percent) chose repeal. That’s about the same proportion who have favorable views of the Tea Party.

Which may be why the new anti-ACA ads being run by a Koch brothers-funded group against Democratic Senate candidates in several states do not call for repeal. The ads take a populist, anti-insurance company approach usually used by Democrats. One ad in Iowa targets the Democratic Senate candidate, Rep. Bruce Braley, for taking “tens of thousands from his friends in the health insurance industry.” Rather than calling for outright repeal of the law, the ad says simply, “stop supporting Obamacare.”

But the intensity is still, admittedly, on the side of opponents, who care more about the issue and are more likely to vote – especially in a low-turnout contest like the 2014 midterms. For Democrats to take advantage of the ACA’s success on the ground, they must both make it a motivating issue for their base and reach out to independents, who remain skeptical about the law.

In 2010, Democrats made the unforgivable mistake of not answering GOP attacks on Obamacare, mostly aimed at seniors. In truth, Democrats designed the ACA to quickly deliver Medicare benefits to seniors, in the form of lower prescription-drug costs and free preventive care. But instead of campaigning on that, Democrats allowed Republicans to scare seniors about cuts in Medicare. (Never mind that Republicans were simultaneously complaining about the law’s supposedly exorbitant costs or that House budget keeps these cuts.)

This year, most Democrats understand that they cannot ignore the issue. We can see a new political strategy emerging in a campaign ad that targets the most important group of voters for Democrats to turn out: women. A super PAC supporting Sen. Mark Begich, the Alaska Democrat, is running an ad featuring a well-known woman who is a breast cancer survivor. She talks about how she had been denied care due to a pre-existing condition. As she jogs through the snow, she says, “I now have health insurance again because of Mark Begich. Because he fought the insurance companies, so that we no longer have to.” The ad’s portrayal of a strong woman holds a very powerful appeal to a constituency that Democrats need to turn out in November.

Democratic pollster Stan Greenberg recently told Rolling Stonethat rather than just focusing on economic issues, Democratic candidates should embrace Obamacare. “Not apologizing for Obamacare and embracing it actually wins the argument nationally,” he said. “And it produces much more engagement of Democratic voters. That’s a critical thing in off-year elections.” (President Obama evidently agrees.)

Another Democratic pollster, Celinda Lake, recommends that candidates make the failure of some Republican governors and state legislatures to expand Medicaid a central issue. Lake told me that Medicaid is popular with two out of three voters, who are sympathetic to a state-run program and angry that, for partisan reasons, Republicans are allowing their tax dollars go to other states.

As the Bloomberg poll shows, most voters actually have a sensible policy position on the ACA: Keep the law with some changes. “Keep what’s right and fix what’s wrong,” is the message Alex Sink used in her ads in Florida’s special election this past March. Her response to her opponent David Jolly’s call for repeal of Obamacare was that he wanted to “go back to letting insurance companies deny coverage” and “force seniors to pay for prescription drugs.” Although Sink lost the election, polling showed that independent voters in the district supported the “keep and fix” position over the “repeal” position by a margin of 57 percent to 31 percent. Sink actually gained ground over Jolly during the election on the question of which candidate had a better position on the ACA.

None of this is to say that the ACA will not continue to be a potent weapon for Republicans to use in turning out their base or keeping many older voters, who turn out reliably in midterm elections, on their side. The GOP remains convinced that Obamacare is a symbol of the president’s failure and a winning issue all the way down the ballot. But the law is here to stay, and the longer it stays, and the more people who directly benefit from it, the more popular it will become. Even if Republicans gain control of the Senate in 2014, repeal will be blocked by a Democratic filibuster, backed by a presidential veto.

Worse yet for the GOP, 2016, a year favoring Democratic turnout, looms. By then, the number of Americans who are directly benefiting from the law will have increased significantly – to 25 million newly insured, according to the CBO. Republican candidates, who will likely be forced to continue to push for repeal to win their party’s primary, will be handing an issue to their Democratic opponents. And by 2017, Congress might finally start doing what it is supposed to do, and what most Americans want it do to: Debate how to fix the Affordable Care Act, not how to destroy it.

So, Ted Cruz, you did get one thing right: Obamacare isn’t going anywhere.