Depending on who you ask the Supreme Court's decision upholding the Constitutionality of the Affordable Care act was a victory for everyone. In reality it is a victory for everyone as rising health care costs and and aging population made action necessary at the juncture, but that's not the victory anyone is claiming. On the one hand Democrats claim victory in the bill's constitutionality and Republican's claim victory in the court's semantic decision to call it a tax. As one door to repeal closed another one opened up. Now that Obamacare is a tax, Republican law makers say they never would have voted for it. The problem with that logic is the individual mandate, or penalty, or tax however you want to call it is and will always be the Republican solution to health care reform.
Let's go back to primary season 2008 and gets all the facts in order. Vying for the democratic nomination was Barack Obama and Hillary Clinton. With all the data on rising health care costs and it's increased share of our spending reducing health care costs became the issue of the primary. Clinton, who did not win, advocated for a solution involving an individual mandate while Obama offered a single payer system in contrast. Obama won. The people decided they liked his plan better. Once elected Obama faced the task of bridging the gap between two historically polarized camps. In fact when Democrats took control of the Senate in the 110th Congress, the Republicans countered by dragging their feet at a historic pace filing for cloture and invoking the filibuster 139 times in the course of the legislative session. Unfortunately for members of the 110th, records are meant to be broken and the current congress has their record well with in their sights and should crush the old record of futility. In total, the filibuster has been invoked well over 300 times in Congress since Obama took office, that total was not reached by all sessions of Congress from World War I on through to Regan's day, roughly 60 years of Congressional history.
This was the political climate in which the Affordable Care Act was written, contentious to say the least. The level of contention in Congress had a great deal of influence on what was possible politically. From the outset President Obama pursued a course different from the one he had laid out on the campaign trail. Single-payer was suddenly not an option despite the general will's (Rosseau reference intended) approval at the ballot box. Obama instead sought bipartisan solutions to health care reform as he needed progress on the major point of his campaign for political capital. This is how we re-branded Romneycare the Affordable Care Act, or Obamacare, or socialism, or fascism, or death panels...etc. Despite whatever the accusation du jour is, this program is and will always be a compromise featuring far more Republican ideas than liberal ones, and that was it's political intent from the outset. The only liberal idea in the plan is in implementing a plan.
Romneycare, and Obamacare are ostensibly the same plan. Both created exchanges where private insurers compete and individuals are required to purchase insurance. One notable difference between Romneycare and Obamacare is the size of the penalty/tax/income redistribution/latest talking point. In Romney's plan the penalty for those who do not purchase insurance is nearly twice that of the ACA's penalty clocking in at $1,200 v. $695. Both plans also rely on government subsidies for people who can not afford health insurance making larger member pools, something the insurance industry doesn't mind one bit. In fact insurance companies themselves had a hand in writing large portions of the each bill so it is increasingly difficult to pin down the ideology behind it to the Democratic party, especially those of us who've advocated single payer all along (Zero points for consistency in politics I'm starting to learn). Continuing with the similarities both plans also contain employer mandates requiring businesses to insure their employees. Let's keep it going: both plans allow children to stay on their parents insurance until they are 26, both forbid insurers from placing limits on the benefits someone can receive in their lifetime or a given year, both require insurers to cover people with pre-existing conditions. As Jonathan Gruber, who helped write BOTH bills, so eloquently put it, "[they are] the same fucking bill."
Cognitive dissonance is unfortunately the default position for the GOP on all issues and health care is no different. Log cabin Republicans vote against their own human rights, hawks send anyone but their own children to war, the populist Tea Party pushes a corporate agenda, deficit slashing candidates become expansionary elected officials, and the no tax ever pledging party is now trumpeting their only idea on health care reform as a tax. How could Grover Norquist endorse Romney if he raised taxes while Governor of Massachusetts while also signing his silly pledge. Cognitive dissonance. The Republican party's newly found obsession with calling the mandate a tax is just further evidence of that. I would like to present the GOP with a similar challenge to the one they constantly pose to themselves: here's YOUR cake, have it, or eat it. Choose one.