Markos Moulitsas argues it will:
Had Republicans embraced their Heritage-devised plan, worked with Democrats to best shape it in their mold, then accepted this market-based approach in bipartisan fashion, Obamacare’s numbers would look much better. And if overwhelming majorities approved of the plan, any hope of future progress on the issue would be dead in the water. Republicans might not have their ideal (i.e. screw the uninsured), but their CEO buddies would still be living large and they’d still be able to boast of a market-based solution in line with their political ideology.
But with approval of the law still in iffy territory, liberals have room to agitate for further improvements without having to tackle an entrenched and deeply popular law. And with Republicans refusing to allow even minor technical fixes to the law to improve its efficacy, their continued undermining of the law makes it just as easy in the longer term for liberals to push for bigger and broader chances.
There’s a lot taken for granted in these two short paragraphs. But Markos is absolutely right that by failing to embrace the ACA and do everything in their power to make it work, Republicans have left liberals with the political space to argue in favor of single payer. Any failure in any part of the ACA provides space to argue for single payer – Republican governors reject Medicaid? They wouldn’t need to if every American were covered by Medicare for all. Insurance companies still find ways to cancel policies? That wouldn’t be an issue if we had a single payer system.
Here’s my pushback to Markos’ argument: Republicans shut down the government to defund the ACA. They’ll crash the world economy to prevent single-payer. More problematically, however, is that the ACA will work well enough that Dems won’t want to take on that bruising political battle again. We need a Democratic majority in Congress to make the technical adjustments any large law requires, to make the ACA work then to introduce a public option. At that point, my instincts tell me market forces will end up driving us to single-payer.