In the LA Times today, Noam Levey writes that Obamacare has an ace in the hole: the insurance industry. Sure, they have their gripes:
But since 2010, they have invested billions of dollars to overhaul their businesses, design new insurance plans and physician practices and develop better ways to monitor quality and control costs.
Few industry leaders want to go back to a system that most had concluded was failing, as costs skyrocketed and the ranks of the uninsured swelled. Nor do they see much that is promising from the law's Republican critics. The GOP has focused on repealing Obamacare, but has devoted less energy to developing a replacement.
.... For many of these organizations, the prospect of new customers and a more rational system outweighs their sometimes intense irritation with the Obama administration. Insurance executives, in particular, have gnashed their teeth at the president's attacks on their industry....Despite the frustrations, most insurers remain committed to moving to a new market that would achieve the central promise of the Affordable Care Act: that all consumers can buy health plans even if they have preexisting medical conditions.
This is really a crucial point. Like it or not, the entire health care industry has spent the past three years gearing up for the rollout of Obamacare. At this point, they're committed—and doubly so since the Republican Party very clearly has no real alternative for them. This means that all the doom-mongering on Fox News is basically just chum for the rubes: Obamacare isn't going anywhere, and everyone knows it. The health care industry will do everything it can to make it work, and one way or another, it's going to work. Even the Medicaid expansion is almost certain to be taken up eventually by nearly every state as passions cool down a bit and hospitals start complaining about the lost income.
The tea party may not quite know yet that it's lost the war, and Republican politicians have every reason to egg them on in this delusion, but the war is well and truly lost. It's all mopping up now.