So how did lawmakers manage to overcome the partisan paralysis surrounding Obamacare? In large part because they didn’t tell anyone they were changing it.
The first change passed both the House and Senate by voice vote—meaning no roll call was recorded—within a few days at the end of September and the beginning of October, a time when the Capitol was preoccupied with who would replace John Boehner as speaker of the House. There were no celebratory press conferences, and no bill signing at the White House. When I asked Republicans and Democrats about it last week, a few didn’t even know the policy they voted to change—an irony given how many Republicans complained that Democrats didn’t even read the 2,000-page Affordable Care Act before they passed it in 2010.
The repeal of the auto-enrollment requirement was tucked into the 144-page budget agreement that was unveiled just before midnight on a Monday and passed by both chambers of Congress about 75 hours later. Republicans claimed it as a victory for their side in the negotiations, while Democrats barely acknowledged it. Privately, Democrats told me the Obama White House had approved of the provision. “It wasn’t something Democrats or the administration really cared about,” said one House Democratic aide, granted anonymity to discuss what is still a sensitive subject. “There is nobody on our side who is losing any sleep over this provision going away.” When I asked Senator Charles Schumer, the third-ranking Democrat, about the Obamacare provision, the only thing he would say on the record was that he hoped Republicans “had given up their repeal crusade, because it’s going to fail.”
Republicans haven’t entirely given up that effort, at least publicly. But in the last couple of years it has comprised little more than show votes orchestrated by party leaders to demonstrate to conservative voters that they haven’t forgotten about repealing the Affordable Care Act. But their heart isn’t really in it, and hard-liners in Congress have noticed. Senators Ted Cruz, Marco Rubio, and Mike Lee have all vowed to oppose a House-passed repeal bill designed to circumvent the Senate filibuster because, they say, it doesn’t throw out the entire law. (Supporters counter that because of complex budget rules, that’s as far as they could go while still hoping to get a bill to Obama’s desk.)
Most Republicans have long since acknowledged that any hope of repealing Obamacare must wait for a GOP president—and probably a few more votes in the Senate. “Republicans have accepted the reality that as long as there’s a president named Barack Obama, Obamacare will not be repealed,” Representative Charlie Dent said. “At the same time, Democrats are acknowledging that there are some real problems with this law that need to be addressed.”
Will these pair of changes wind up as a blip on the partisan record of the Affordable Care Act, like the revisions that Obama signed in 2011 and 2013? Or do they signal a parting of the clouds over the law, a “normalizing” that will lead to the regular updates and tweaks that were made to Medicare, Medicaid, and Social Security in the years after their enactment? If it’s the latter, the list of suggested amendments is growing. Under pressure from unions, Hillary Clinton came out in favor of repealing the ACA’s “Cadillac tax” on high-end insurance plans, a policy that was controversial when the law was enacted but is a key part of its financing. There’s been a similar bipartisan coalition pushing to repeal the medical-device tax, and a more recent effort to relax other regulations on small businesses in the law.