The Coming Democratic Civil War Over Obamacare

 Conn Carroll,

 Politico has a story out today on the brewing fight between Maryland Attorney General Doug Gansler and Lt. Gov. Anthony Brown over Obamacare. The catch is, both are Democrats, yet they are still attacking each other over President Obama’s signature domestic accomplishment:

In Maryland, the fight to succeed outgoing Democratic Gov. Martin O’Malley has pitted Gansler against … Lt. Gov. Anthony Brown, the frontrunner for the nomination who chairs the state panel on ACA implementation and has long presented himself as the O’Malley administration’s point man on Obamacare.

obamacarei_small5 The Coming Democratic Civil War Over Obamacare

After vowing to make deep-blue Maryland an ACA success story, Brown – and O’Malley – watched with dismay as the website for the Maryland Health Benefit Exchange floundered, allowing fewer than 4,000 Marylanders to enroll in insurance plans by the end of November. The executive director of the state exchange resigned at the start of December.

In some respects, the Maryland race is a unique one: No other state on the 2014 map features an open-seat contest for the heart of the Democratic base between two major candidates, one of whom was directly tasked with implementing a state health care exchange.

That last paragraph is a little overdrawn. Yes, the Maryland Democratic gubernatorial primary will pit the man in charge of the state’s Obamacare implementation against an opportunistic rival, but it is hardly the only deep-blue state where Obamacare’s failure will be an issue. Just look at Massachusetts, where Obamacare architect Don Berwick is running in the open Democratic primary for governor.

His platform? Obomneycare has failed to control health care spending, it is busting Massachusetts’ budget, and therefore Democrats must embrace single-payer to fix the health care system. From Berwick’s campaign website:

In the Massachusetts state budget, almost every key line item has gone down by 20%, 30%, or 40% in real terms since 2000 except health care, which has gone up by 60%. In 2013, 43% of state expenditures are for health care – that’s more than double what we spend on education.

It is time to explore seriously the possibility of a single payer system in Massachusetts. The complexity of our health care payment system adds costs, uncertainties, and hassles for everyone – patients, families, clinicians, and employers. I will work with the Legislature assemble a multi-stakeholder Single Payer Advisory Panel to investigate and report back within one year on whether and how Massachusetts should consider a single payer option.

The rest of the country may have already concluded that Obamacare, as written, is a total failure, but it will take the base of the Democratic Party much longer to admit the truth. Already, however, almost 35 percent of Democrats tell CNN that they oppose the new health care law. That number will only grow.

By 2016, it may be untenable for Democratic White House candidates to support Obamacare as is. Instead, each candidate will have to come up with their own Obamcare “fix.”

If Berwick’s single-payer platform carries him to victory in Massachusetts, it will be hard for 2016 candidates not to follow his example.