Guess who is now claiming, at least implicitly, that Obamacare isn't working? Democrats.
That's the silent premise on which the argument in favor of "Medicare for All" rests. And it is reasonably clear that the 2020 Democratic presidential nominee will be running on Medicare for All.
Obamacare (or the Affordable Care Act) was supposed to fill in the holes in our health insurance system, effectively providing universal coverage.
There is Medicare for the elderly and Medicaid for the poor. Obamacare was supposed to guarantee comprehensive health insurance coverage for everyone else.
The federal government dictated benefits for employer-provided plans. Those without coverage at work could buy the equivalent through the Obamacare exchanges. In the exchanges, there would be a ban on medical underwriting and a limit on profits. And subsidies based upon income.
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The call for Medicare for All is a statement that Obamacare has not worked.
Enrollments in Obamacare plans are substantially below projections when it was passed, and were even before Republicans eliminated the individual penalty for not having insurance as part of the tax cut legislation. The penalty goes to zero this year, and Obamacare enrollments have actually dropped.
There are things that the Trump administration and congressional Republicans have done to increase alternatives to Obamacare, such as extending the duration of gap coverage not subject to all the Obamacare restrictions and mandates.
The politics of Obamacare
But what is politically significant is that Democratic aspirants aren't running on beefing up or fixing Obamacare. Some Democrats are calling for it to be replaced with Medicare for All.
Of course, Medicare for seniors is running out of money for hospitalization coverage. And Democrats are coy about how to pay for Medicare for All. The only possible source of enough money would be a European-style value-added tax to pay for the European-style health care system.
That said, a national debate about making health care a public good provided, directly or indirectly, by government is worth having. Republicans have failed to develop a market-oriented alternative with a sturdy enough safety net for those seriously or chronically sick.
But it should be understood that the debate is based upon a now shared view that Obamacare has been a bust. It does give those seriously or chronically sick access to a limited provider network. But it has ruined the individual health insurance marketplace for everyone else.
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This article originally appeared on Arizona Republic: Democrats are the ones complaining about Obamacare