I have a friend in Sydney, Australia who has things a little tough. She has a decent professional job – though its a job in a woman’s career, so it doesn’t pay as well as professional jobs should – and she’s a good worker. She has been working ever since I met her without a break, and keeps the same job for years at a time, so no problems with her work life. Unfortunately she’s a single mother, not because she’s one of those dirty sluts who pop out sprogs by the month to get on welfare, but because after the birth of her child her husband turned into a weirdo Men’s Rights Activist and became insufferable, so they divorced. They have a custody arrangement (one week each) so she doesn’t fall afoul of any of the Men’s Right’s Movement demands for Good Women, but that’s not enough for him: when her child is at her ex’s house he denigrates her verbally, and he refuses to pay for any kind of extra-curricula or developmental activity, so if her child wants piano or ballet or rugby lessons, she has to fork it out herself. Nonetheless, her child is well-adjusted and she’s a good parent.
Unfortunately she has a minor mental disability which, although it doesn’t stop her working and raising children, means that she isn’t so good with money and she’s had a long history of financial troubles. It also means that she has a “pre-existing condition,” and anyone who has lived in Sydney knows that rents are punishing and being dodgy with money is not an easy trait to live with. She’s lucky because she has a good job, but for every person like my friend you can bet there’s another similar person whose job is not so great, who has serious financial troubles and is, as they say, a single pay-cheque away from disaster.
I think I know what this situation is like, though I can’t imagine the additional stress that gets piled on when you have a child, and I can imagine that my friend comes home from work sometimes, sits down and lets out one of those slow breaths, the one’s where you’re mentally thinking “Fuuuuuuck” as you wonder at what you can do and worry about what will happen to you if you don’t do it.
Fortunately, however, my friend lives in Australia, so she is guaranteed health care. She knows that no matter how badly things go, even if she isn’t working (which she is), neither she nor her child are going to lose their health. Which means that if it becomes her goal to shift down from her professional job to a manual labourer, cleaner or bar worker – she will still have guaranteed healthcare. Those weekly worries where she sits down and thinks about what she has to juggle don’t extend to her or her child’s health.
Not so in the USA. The same woman in the USA – changed jobs as an adult, pre-existing condition, child with same pre-existing condition – is likely unable to get health insurance even if she can afford it. The same woman in the USA will come home and she won’t just think “can I afford anything nice for my child this weekend or next,” but will also think “I hope I don’t get seriously sick before my child becomes an adult,” because if she does she will be facing ruin, and her child’s future will take a massive nose dive. Even though she can afford health insurance in any other country in the world, in the USA she will be denied it, or her entire income will be blown on it. And she’s not alone, nor is her case limited to single mothers who had the importunacy to refuse to tolerate Men’s Rights Movement husbands – there are between 10 and 40 million Americans who can’t get health insurance, and for a sizable proportion of them the problem is either that they have a pre-existing condition, or that as sole business operators or independent contractors they don’t have group purchasing power, and simply can’t afford individual insurance.
But not anymore. On Monday Obamacare started, and those millions of people have access to the health insurance exchanges. Insurance companies can no longer refuse them insurance, but have to offer them a basic plan, and the government will subsidize some plans. Medicaid has been expanded to cover the working poor. The primary beneficiaries of Obamacare will be the working poor, the lower middle class, and those with pre-existing conditions. The estimate for the first year is that 7 million people will gain access to health insurance, and the total number of people expected to gain access over the long term is 28 million. This isn’t a flight of fancy either – the Health Insurance Exchanges have been overwhelmed by the unexpected number of customers, just as happened to the NHS when it first opened.
This scares the Republicans. The next presidential election is in two years and they desperately need to win it, but they have a problem: they are implacably opposed to Obamacare. The election is in two years, and the prediction is that in one year 7 million people will take it up. This means that by the time of the election 7 million people will be benefiting from a Democratic policy that the Republicans will be campaigning to abolish. Judging by the scramble to the exchanges, many of those people will have been receiving their insurance for more than a year. For those people, that Friday night collapse onto the couch and “oh, what am I gonna do!?” will no longer include worries about healthcare. If they have two years to experience this level of relaxation and then, at the next election, the GOP and its Tea Party mates rock up claiming a virtue of abolishing the law, what are those 7 million people going to think? Will some of them perhaps think one option is voting?
Furthermore, the biggest beneficiaries of Obamacare are going to be working and lower-middle class white males with families. These are the stalwarts of the Tea Party’s campaign, and in the long term they are going to be looking at convincing up to 40 million people that gaining access to health insurance – including subsidies for the working poor – is a bad idea. What are their chances?
This is why they have to throw down now. This is why their specific condition was that Obamacare be delayed a year. They need those 7 million people to be naive, fresh to Obamacare, not yet settled in their new comfort zone, so that they can go to the election with a slogan that appeals to their base and doesn’t simultaneously alienate – or worse still, activate – 7 million early adopters. With a one year delay they have a chance; if Obamacare is enacted now they lose. And if they lose, they lose the following election too, because whoever wins the White House (Hilary Clinton?) is going to be able to say to more than 7 million new Democrat voters “do you trust these people? Last election they said they would remove your health insurance. Do you trust them this election?”
That’s why the GOP is willing to shut down the government, because in two years time they risk irrelevance. They have to destroy the tea party and accept universal health coverage, or they have to fight. And if they choose to fight there is going to be no room for compromise. Will they go so far as to force a default? Do they have any political reason not to, if they are facing a sea change at the next election? I guess not …