Everything is Obamacare!

The new GOP attack on the Medicaid expansion is that it's indistinguishable from the dreaded Obamacare.

Eight Republican governors have accepted the Medicaid expansion for their states—and one of them, Chris Christie, leads the Republican Governors Association. But this hasn’t stopped them from attacking Democrats for pushing it as well. To wit, in South Carolina, the RGA is running ads against State Sen. Vincent Sheheen, who is challenging Governor Nikki Haley for the state’s governorship.

“Remember this guy, Sheheen? Well first, Sheheen supported much of Obamacare. But then he refused to support the lawsuit to stop it,” says the ad. “Now, Vincent Sheheen wants to use Obamacare for a $2 billion expansion of Medicaid in South Carolina.” Here’s the full ad:

If last fall’s gubernatorial election in Virginia was any indication, the Medicaid expansion will play a key role in Democratic efforts this year. The pitch is straightforward: The Affordable Care Act has its problems, yes, but it’s foolhardy to reject federal funds and block health care for our poorest residents. If there’s a strategy behind this RGA ad, it’s to neutralize this appeal to self-interest by blurring the lines between the Medicaid expansion and “Obamacare.” If a program takes money from Obamacare, then by the property of transference—according to Republicans—that program becomes Obamacare.

There’s no doubt this will work in South Carolina, where the law is incredibly unpopular. The question for Republicans is whether it plays in places where the public is amenable to something like the Medicaid expansion. What’s more, this approach is interesting for what it says about the broader politics of the Affordable Care Act. If everything associated with the law is Obamacare, then it’s hard to imagine a world where GOP lawmakers in GOP states are willing to do anything to implement the program. Opposition to the Affordable Care Act in toto might linger as a litmus test for conservatives.

As for Republicans who took the plunge to expand the program? Don’t be surprised if they square the circle with branding magic, so that voters don’t associate their Medicaid expansion with the dreaded Obamacare. Kentucky’s “Kinect” was pushed by a Democratic governor, but it stands as a good example of the phenomenon. In which case, Republican voters can reap the benefits of the Affordable Care Act, without the explicit connection to Barack Obama.