What a difference four years -- and millions of people with health insurance -- can make in the Republican presidential campaign.
In 2011, the last time GOP candidates for president gathered for a debate at the Ronald Reagan Library, the topic of the Affordable Care Act came up early and often.
Right near the beginning, Mitt Romney got a tough question about the Massachusetts health care law he signed -- a program that became the prototype for the Affordable Care Act. Rick Perry, then among the most vocal opponents of “Obamacare,” was pressed on how he would address the problem of the uninsured if the Affordable Care Act came off the books.
Jon Huntsman described his own preferred alternative to Obama’s health care law; Rand Paul expounded on the dangers of government meddling with health care markets. And when Michele Bachmann got a question about the economy, and what she’d do to create jobs, she used it as an excuse to talk about the (alleged) damage the health care law was doing to the business climate.
On Wednesday night, for this year’s debate at the Reagan Library, the health care law got almost no attention at all.
Donald Trump made a quick reference to it during his introductory remarks, and Ted Cruz made his usual promise to repeal the law. But the only sustained discussion came in response to a question about the summer Supreme Court decision rejecting an anti-Obamacare lawsuit. And that was a conversation about Chief Justice John Roberts, his supposed act of heresy, and what kind of justices the Republicans would appoint to serve on the Court. Health care policy didn’t come up.
So why didn’t the CNN hosts ask about it? Why didn’t any of the Republican candidates strain to bring it up, the way Bachmann did in 2011? Here’s one theory: The issue is losing its resonance, even among Republicans.
No, the law is not popular. When pollsters ask respondents whether they like the law or approve of it, usually pluralities and sometimes even majorities say no. But recent surveys suggest that opposition may finally be softening, the issue is not dominating the headlines anymore and another issue, immigration, is become the GOP's chief preoccupation.
This is happening at a time when millions of people are getting health insurance through Medicaid and regulated private insurance -- and, as a result, the proportion of Americans without health insurance is reaching historic lows. The components of the law are also pretty popular. Whatever people feel about the law in theory, they like the protections it provides in practice -- the guarantee of comprehensive insurance for people with pre-existing conditions, for example, and the generous tax credits for purchasing private coverage.
Support for those features actually isn’t new. Polls have picked it up for a long time. In 2011, that support simply didn’t matter, perhaps because the benefits were purely hypothetical. Now they are real -- and making a difference in the lives of millions of people. Maybe that’s why Republicans are a little more skittish now.