Of course as Republicans attempt to undermine the ACA a thousand different ways (denying funding to key components, refusing to implement Medicare initiatives, undermine enforcement efforts, spreading objectively false propaganda about the law, etc.) the outcomes become more and more compromised.In a policy debate, it can be helpful to clarify what each side's claims are. Doing so makes it easier to see whose predictions are ultimately borne out by reality, or at least which parts of divergent expectations prove most accurate. It also makes it harder for people to conveniently claim after the fact that what is occurring was what they were predicting all along.
We're seeing that already from supporters of the Affordable Care Act, aka Obamacare. At first, their assertion was that the law would make health care, well, as the name implies, more affordable. Insurance premiums were supposed to come down, and overall expenditures on medical treatment were supposed to decline as people gained access to "preventive" services.
Over time, as rubber has met road and more evidence has pointed toward an increase rather than a decrease in health care costs, Obamacare proponents have quietly begun a major bait and switch. Once certain the law would lead to across-the-board reductions in insurance premiums ("We estimate we can cut the average family's premium by about $2,500 per year," quoth then Senator Barack Obama), today they argue that the purpose of the law was never to make health insurance cheaper for everyone.
Instead, they say, the ACA was meant to broaden the swath of Americans who could access health care by prohibiting insurance companies from turning away or charging more to people who are sick. And if some people have to pay more than they otherwise would, it's OK, because they'll also be getting more in the form of benefits they don't want!
Needless to say, ACA opponents' concerns have not been assuaged by this seventh-inning copout. Yet there's still plenty of time for either side to be proven wrong. Many key pieces of the legislation won't go into effect until the beginning of 2014, and even then, prices could take time to settle into their new equilibria. A fair assessment will be the one we can only make two or three or four years down the road, after the policies enacted have had the chance to bring about– or not– the outcomes promised by their supporters.
Until then, I think it worth stating plainly what Obamacare opponents like myself actually see coming. This establishes a fair yard stick for measuring the correctness of our predictions and makes it harder for the other side to decide on our behalves what we "really thought would happen." (It also gives them a petard with which to hoist us if we turn out to be wrong.)
When the law was passed, Democrats acknowledged that there were lots of flaws in the law as a result of attempts to compromise with opponents. A reasonable Congress would address those individual flaws to make the law a good as possible. But, since we don't have a reasonable Congress, what has happened instead is that the GOP has exploited and exacerbated those flaws to undermine the law.
As a result, whatever attempts at measuring the law's success will be compromised by GOP sabotage. Several years down the road, every failure will be pointed to as proof opponents were right all along, when in fact they were the ones who caused those failures.