Ready Or Not, 'Obamacare' Rolls Out As Planned

Millions of people have shopped for insurance on the new marketplaces called exchanges since opening day on Tuesday. Officials said it was evidence of high interest. Others criticized the fumbling start, which involved computer glitches, saying the Affordable Care Act was not ready for prime time. Renee Montagne and David Greene talk to NPR's Mara Liasson and Molly Ball, of The Atlantic, about the politicking around the new health law.

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RENEE MONTAGNE, HOST:

And all of that happened yesterday in what has been a charged week at the Capitol. Republicans in the House stuck to their demands to defund the Affordable Care Act and parts of the government remain shut down.

DAVID GREENE, HOST:

Still, Obamacare rolled out as planned. Millions of people have shopped for insurance on the new marketplaces called exchanges since opening day, Tuesday. Officials said it was evidence of high interest, but others criticized the fumbling start which involved computer glitches and slowdowns, saying Obamacare was just not ready for prime time.

MONTAGNE: We want to talk about how, now that the new health care law is real, how that is affecting the politics of it. We're joined in our studio by NPR's Mara Liasson and Molly Ball, who writes about politics for The Atlantic. And good morning to both of you.

MARA LIASSON, BYLINE: Good morning, Renee.

MOLLY BALL: Good morning.

MONTAGNE: Mara, let's begin with you. How did all of this play out in national politics this week?

LIASSON: Well, of course, Obamacare is at the heart of the current crisis in national politics - the standoff over the shutdown and the debt ceiling and where Republicans have been demanding a series of changes in the law in return for reopening the government or for raising the debt ceiling. So all of the political attention is over that fight, over the deep divisions within the Republican Party, over the drama of how House Speaker John Boehner will or won't get himself out of the political straitjacket he's put himself in.

And I think that's really overwhelmed the politics of the Obamacare launch. And that is politically a net negative for the Republican opponents of the law, because the glitches probably got less attention than they otherwise would have.

MONTAGNE: And Molly Ball, give this a sense of how this is playing out on the state level because you have written about Republican governors and apparently increasing numbers of them are finding that it's in their political interest to get behind one part of the Affordable Care Act involving money.

BALL: That's right. The federal government, at least in the initial stages, pays 100 percent of the expansion of Medicaid under Obamacare and initially, most Republican governors resisted that and said that that was too much of a federal encroachment. They wouldn't accept it. What we're finding now is those Republican governors who are up for re-election this year and are in states that voted for Obama are almost all choosing to take that Medicaid expansion, take what's essentially free money for the federal government to help cover more of the poor, uninsured in their states.

So, for example, governors like Chris Christie in New Jersey, who's actually up for re-election this year, Rick Snyder in Michigan sort of muscled this through a Republican legislature. You have John Kasich in Ohio, who is trying, who is actually campaigning very hard to get his Republican legislature in Ohio to accept this Medicaid expansion. And these governors' approval ratings have largely increased since they have embraced this one aspect of Obamacare.

MONTAGNE: Well, is that a sign that the Republicans, if not, you know, on Capitol Hill, but at the state level and elsewhere are beginning to acknowledge that they are not going to remove or get rid of Obamacare?

BALL: Something that Democrats have consistently had angst about with this law is that many individual parts of it are popular. Not all, the individual mandate is not popular, but things like the Medicaid expansion, even in a deep red state like Georgia, you have - it polls pretty well. Sixty percent say that they approve of the Medicaid expansion as an individual part.

So it's harder when you are talking about the politics of individual parts of the law than when you're just talking Obamacare overall, which remains unpopular.

MONTAGNE: Well, and of course, the popular part does have to do with funding, so Mara, what are the long-term prospects of funding this new healthcare law?

LIASSON: Well, for the short term, funding is intact. It doesn't come from annual appropriations. In the long term, I think there are two big questions about Obamacare. One is, will enough young, healthy people sign up for the system? And like any insurance system, that will only work if they do, otherwise it'll go into a death spiral and fail.

But the second question about the long term fate of Obamacare is more important politically and I think that has to do with how people with health insurance now react to the law. If they lose their coverage, are forced to go on the exchanges or their coverage gets less generous or more expensive, do they blame that on Obamacare?

And one of the president's biggest promises was that nothing would change for you if you had insurance. It's going to take awhile to know that answer, but that could make what is the net negative views about the overall law more negative or not.

MONTAGNE: Let me just ask both of you; I'll start with you, Molly. Is there any precedent for a major program going into effect at the same time the U.S. government is in the sort of churning, chaotic state that is because of protests against that program?

BALL: I'm not aware of any direct precedent for that, but I think, to what Mara was saying, the reason we've come to this point, the reason this showdown has become so intense and has shut down the government is because Obamacare is going into effect and the opponents of the law see this as their last opportunity to derail it.

There is a feeling that once it gets into the system, especially if it's successful and we don't know that yet, but especially if it's successful, it will be very, very hard to get rid of.

LIASSON: And that's also, I think, why you see, on Capitol Hill, more and more Republicans realizing that a government shutdown, a possible debt default is not going to get them where they want.

MONTAGNE: Well, thank you very much. That's NPR's Mara Liasson and Molly Ball, who covers politics for The Atlantic. It's MORNING EDITION from NPR News.

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