Greg Sargent sees a light at the end of the Obamacare tunnel. Until now, the GOP's only goal has been repeal. But as 2014 wears on, it's going to become increasingly obvious that Obamacare is here to stay. What happens then?
If Republicans do get to a point where crippling or eliminating the law is not the only acceptable outcome, there are scenarios under which they might negotiate for certain types of changes to the law, in exchange for changes Dems or liberals want.
Larry Levitt of the Kaiser Family Foundation laid out the types of incremental changes Republicans might pursue. He suggested Republicans might propose various ways of relaxing Obamacare’s regulations, in keeping with conservative policy ideas, that wouldn’t destroy the law. For instance, they could propose allowing insurance sales across state lines so competition drives down prices, something liberals might be willing to accept under certain circumstances if the law’s uniform federal minimum coverage standards are kept (which could theoretically prevent the “race to the bottom” liberals fear).
There are other possibilities too. Sargent acknowledges that none of this will happen in 2014, and possibly not until after 2016 too. That's my guess as well. And even then, there will probably be only minimal Republican appetite for dealmaking. After all, Medicaid is more than half a century old, and Republicans still aren't willing to cut deals that might strengthen it in return for some conservative policy advances. In fact, they're still dead set on block granting Medicaid as a way of slowly starving it to death.
Obamacare could be different if it becomes widely used by the middle class, not just the poor. Republicans would have a hard time resisting middle-class demands to improve the program. But that's what it will take. And I'd guess that 2017 is about the earliest likely date for Republicans to give up their dream of total repeal.