Tuesday, October 7, 2014

Repeal or reform: Next steps aren't simple

A recent conservative poll found that 60 percent of voters want Congress to repeal the Affordable Care Act.

The Kaiser Family Foundation's polling found the opposite, that 63 percent would rather see Congress work to improve it.

So what's up?  According to a piece by Jeffrey Anderson in The National Review Online,  it's a sign that the Kaiser foundation skewed results by casting the issue as a choice between  "work to improve the law"  and  "repeal the law and replace it with something else."  The political research and strategy firm McLaughlin and Associates offered the options of   "it should remain the law of the land,  either in its current form or in amended form,"  "it should be repealed and replaced with a conservative alternative that aims to lower health costs and help people get insurance,"  or "it should be repealed but not replaced with an alternative"  (the last two combined got 60 percent). 

Anderson is executive director of The 2017 Project,  which promotes a conservative agenda. He argues that Kaiser isn't the  "gold standard"  on health care polling that many in both parties believe it to be,  but  "a pro-Obamacare outfit." 

Given the Observer's decision  (and mine)  to work with Kaiser Health News,  which is funded by the foundation,  I thought that was worth checking out.  It didn't take long to find that the McLaughlin questions were focused on conservative alternatives promoted by The 2017 Project  --  or that Anderson's group commissioned that poll,  which he failed to mention in the National Review piece.  As I reported last month,  the Kaiser poll also found plenty of anti-Obamacare sentiment  --  in fact,  the Kaiser poll got a stronger negative reaction to  "a health reform bill signed into law in 2010"  (49 percent unfavorable to 35 percent favorable)  than The 2017 Project poll got to  "the Patient Protection and Affordable Care Act, also known as Obamacare"  (52 percent disapproval to 43 percent approval).

But there's an important kernel of truth in Anderson's piece when he notes that  "improve the law"  and  "replace it with something else"  are vague options.  That's the nature of public polling;  we get people's gut reaction to broad terms,  not an in-depth analysis.   From what I can tell,  most Americans agree that our health care system needs a lot more work and few of us know how to make that happen.

So here's my suggestion:  If you're trying to think through what needs to happen next year,  check out Politico's recent piece on Obamacare 2.0.  The online magazine asked 15 leaders in the health care scene to describe the next steps.  The authors span the political spectrum.  Some tout the act's successes while others proclaim it a disaster.  But they all talk about follow-up actions,  whether that's creating a single-payer system  (independent Sen.  Bernie Sanders),  rolling out a new system that emphasizes choice and cost control  (GOP Sen. Lamar Alexander) or making adjustments to what's in place.  Reading this piece takes time,  but it's the kind of discussion regular people need to tap into if we want to get beyond sound bites.


Archiguy said...

The political right has mounted a smear campaign for 5 years now regarding the ACA, for no reason other than to weaken the President and hopefully defeat him in 2012. They failed in their stated goal, and their bitterness lingers.

The unprecedented venom we saw directed toward the ACA in the summer of 2009, funded and organized by the Rpublican Party with seed money from the Koch brothers and others, resulted in the creation of the Tea Party, and the malignancy which has overtaken Congress ever since.

There are many who believe the campaign was intended only to gin up hysteria in order to get GOP candidates elected in the decennial election year of 2010 (when redistricting takes place), thereby cementing their majorities in the U.S. House and many state legislatures for at least the next 10 years. Unfortunately for the rest of us, it worked like a charm.

One wonders how many of those opposed to the ACA are actually benefiting from it by finally having affordable insurance for the first time in their lives, either because of a pre-existing condition (which used to be cause for rejection or lost coverage) or because the job they work didn't offer benefits of any kind? Quite a few, no doubt. Low information voters are the lifeblood of the GOP.

The ongoing massive propaganda campaign against the ACA is solely responsible for any negative public opinion. By working WITH the President instead of childishly opposing him, the GOP could have improved the ACA and helped President Obama in his goal of bringing a minimum standard of health care to the 40 million uninsured Americans, including 20 million children, who never had it before.

But that would have been so very unlike them.

Anonymous said...

The CBO has stated that the ACA will cause lower unemployment, fewer full-time employed person and raise healthcare costs for all employer groups. They also recently stated that over the next 10 years, projections for the ACA costs will be 8 times originally costs.

And there's STILL a debate whether we should reform or repeal this debacle????

Anonymous said...

I understand that conservative Republicans don't like the Affordable Care Act (ACA). They would rather use the "racial slur" ObamaCare to fan the racism. But let's be clear about what's going on - HealthCare is not the cause. Over the last 6 years, Republicans have also used this extra-constitutional blackmail strategy to demand cuts in the budget and to try to prevent tax hikes on the richest 1 percent of Americans.

This is not, some extraordinary, one-time response to some extraordinary situation. This has become a routine ploy by a party that has trapped itself in minority status, but that nonetheless insists in its divine right to dictate public policy. If allowed to stand, it will be used over and over again, for increasingly less important reasons, until our system of representative government becomes unworkable.

If you want to repeal a law such as the Affordable Care Act (ACA), the U.S. Constitution provides a process for doing so. You get a majority of the House and a majority of the Senate to approve a bill, and you get President Obama to sign it. If President Obama won't sign it, you need a two-thirds majority in Congress to override him. If your side can't muster the votes to pass a bill, the Constitution provides a longer-term means to correct that problem as well. It is called an "election".

We had an election 2 years ago, and health care was a major issue. But once again, Republicans were stymied. Much to their shock and dismay, President Obama was re-elected, becoming the first person since Dwight Eisenhower to win two consecutive presidential races with more than 51 percent of the vote. Instead of capturing the Senate, Republicans lost two seats. In the House, they lost eight seats, and overall, more Americans voted for Democratic congressional candidates than Republican candidates.

Republicans lack the votes in Congress, and they lack support among the American people to get the votes in Congress.

The American People.....

Wiley Coyote said...

I always find arch liberal Archie's comments as comical as a Seinfeld episode...

Low information voters are the lifeblood of the GOP.

That's a funny quote coming from a memeber of the Democrat Party that goes out of their way to talk about just how inept and dumb many of their constituents are because they are incapable of getting an ID to vote, when the rest of America doesn't seem to have a problem. Or Vilma Leake's classic: "poor people aren't smart enough to steal"...

I'm certainly not benefitting from Obamacare and my premiums have increased higher under Obama than in years prior to.

I'm still able to get insurance from my company which is at this point a lower cost than what Obamacare costs. Unfortunately, when my company gets hit with a cadillac tax, we'll either be tossed into the Obamacare abysss or have our rates skyrocket.

Due to what my household income is, we do not qualify for any subsidies.

So as far as Obamacare goes for me, it's worthless.

By the way Archie. Who do you think pays for your subsidies?

Ans what about the 30 million the CBO projects will STILL BE WITHOUT insurance in the coming years?

Obama screwed up a system where only 10 to 15 million more people "have insurance" instead of targeting those 40 to 45 million who didn't have it to begin with.

Wiley Coyote said...


How's Obama workin' out for ya now?

Democrats are jumping the Obama ship faster than the rats...

Anonymous said...

And, we see yet another employer (in the case, the nation's LARGEST employer) dropping it's part-time employees from it's healthcare coverage because it's too expensive to cover them -- thanks ACA!

BTW Archie, the next time you go to Trader Joe's, thank Obama for having cut the part-timers health insurance coverage. And when you see a working American, thank him for helping to subsidize their healthcare insurance.

P.S. You DID know that 83% of ObamaCare receive a subsidy, correct? Like mentioned above, you DO know who is paying for that, correct?

Republicans had alternatives to the ACA but with Harry Reid already blocking 300 pieces of legislation Conservatives have put forth before a vote, do you honestly think Harry and his ilk, would allow such a thing before the Senate?

Anonymous said...

Obama care did not have to be a failure. All he had to do was introduce a plan that learned from what has and has not worked for the Brits, the Canadians, etc., etc., and, if he couldn't get something of that nature through Congress, then pull it off the table until somebody could. He seemed to be so intent on passing something for the good of his ego and not for the good of the country, that he pushed thru a program that could never work. I voted for him twice, but i think he will go down as one of our ineffective presidents. Too bad .

Anonymous said...

The funny part is the majority of the ACA was written by Republicans and the Heritage Foundation, which is a conservative think tank, in the early 90's. The only changes were the parts where pre-existing conditions still being covered and a few other areas. The mandate to purchase insurance was in the plan then. But since Obama could get it passed when they could not for almost 20 years nor could they bring alternatives, they are throwing a fit about it.