As someone in the comments at the Washington Post notes “How can you make something “great again†that wasn’t great in the first place?” Catherine Rampell gives it a shot
Make Obamacare great again — call it Trumpcare
Believe it or not, Americans like Obamacare. They just don’t know they like Obamacare.
That is, the law known as “Obamacare†and “the Affordable Care Act†is relativelyunpopular. But most of the things that this disreputable law does are incredibly popular.
Consider the prohibition on denying insurance coverage due to preexisting conditions. Seven in 10 Americans, including 6 in 10 Republicans, support this provision, according to a recent Kaiser Family Foundation poll.
What about allowing young adults to stay on parents’ plans until age 26; eliminating out-of-pocket costs for preventive care; providing subsidies to low- and moderate-income Americans to help them purchase coverage; and helping states expand Medicaid to cover more uninsured low-income adults?
At least 80 percent of Americans are fans of every one of these provisions. Among Republicans only, at least two-thirds are, too.
Let’s not forget, those were thrown in to make Ocare popular, to go with all the things, like the taxes/fees/fines, higher premiums and deductibles, lower levels of care, government involvement, etc, that aren’t.
The only major component that a majority of Americans don’t like is the individual mandate — that is, the requirement that nearly all Americans sign up for insurance or pay a fine.
But as is often pointed out, you need this unpopular provision to preserve the popular one about preexisting conditions. Without a mandate, only increasingly sick people will buy coverage, sending insurance markets into a death spiral.
Except, that’s who is buying a goodly chunk of the Ocare plans via the government run markets.
All of which is to say that Obamacare does not have a policy problem. It has a branding problem.
Quite a bit of the problem is the rule making. The slapping on taxes for things like medical devices and device development and tanning salons, the contraception mandate (which, once again, is not even mentioned anywhere in the bill, nor is sterilization nor abortifacients), setting the work hours and which companies get nailed, the exemptions for lawmakers and some unions, etc.
Americans don’t even recognize Obamacare’s one inarguable accomplishment: the precipitous decline in the uninsured rate.
Which could have been done without the giant tentacles of government insinuating into our lives to this degree. Of course, the point of Ocare was not to succeed, but to fail requiring the creation of a public option, leading to Single Payer.
Trump may have little interest in policy, experts, numbers, details. But he is undoubtedly a marketing genius. One possible outcome of the current repeal-and-replace free-for-all is that congressional Republicans decide to keep essentially the existing system in place, with some reforms, improvements and hole-plugging, and Trump slaps a shiny new name on the whole thing.
Welcome to the revolutionary, gold-plated “Trumpcare.†Has a nice ring to it, don’t you think?
Nice wish. Won’t happen. What will most likely happen is that all the things mentioned at the beginning are retained, while all the bad parts, all the parts that increase the power of the federal government, are toasted. There are entirely too many things to just fix. Toast the law, you toast all the rule making. For instance, people would be able to save as much as they want for their Health Savings Accounts, which are limited per Ocare. There are just too many problems.
What they really want is the preservation of the Exchanges (which are utterly failing at this time), so, as they collapse, they can continue to push for the public option then Single Payer. They’re thinking long term. What if Trump utterly fails, and loses in 2020? He could easily take the Congress with him, putting Democrats back in position to attempt their government solutions to a greater degree. They’re playing the long game.
The Republicans don’t care about the healthcare of Americans, but they do care about staying in power. Their ideological preference is to have no gov’t involvement in healthcare, but will sop the people with either genuine help, or more likely more propaganda. They will likely keep the most popular aspects of the ACA (voters!) while bashing the least popular (mandate and piecemeal taxes to pay for it).
The faux “repeal” is propaganda.
I didn’t read the whole article but what about the ‘Cadillac plan’ tax(fine)? This ONE thing is what is responsible for my insurance costs going up 700+%.
As for those other ‘popular’ aspects…
the pre existing condition provision is another reason rates have skyrocketed. My wife fell under this at one time when I changed jobs. She had a one year waiting period and was then completely covered. Not all that bad and most, if not all, insurance plans had this provision for pre existing conditions. All this provision in the ACA does is give people a loop hole to only buy insurance when they need it. This was the argument against this provision and still holds true.
I can understand keeping kids on insurance until 26 but ONLY if they are in school or some other reason why they can’t work and get their own insurance.
So no, the whole thing needs to go and just reform the insurance and health care regulation.
No solution that will please anyone….the minute you tell a company they can only make x dollars…..they will do everything they can to stretch those x dollars by laying people off, cutting the quality of their services in order to continue to make a profit.
This is the biggest angst among the right is in telling the healthcare industry that you can only make pennies on the dollars……..
the left believes that all Doctors, hospitals and medical response personell should be altruistic and spend 16 years in college to earn what a plumber earns……..why not be a plumber?
There is no solution that both sides will ever agree too because both sides have totally different views of what healthcare is all about……..to the right its a business…..to the left its a social service that should be equally available to all…..to the right its like cable or a cell phone….if you can afford it….go for it….to the left its I got me a FREE OBAMA PHONE……To the right healthcare is a necessity that costs money and is paid mostly by employers whom they work hard for for years and years………to the left it is a gift bestowed upon them by the altruistic government paid for by those that work hard and have to pay even more taxes……
In short……both sides are so very, very, very, very, very ffffaaaaarrrrr away from middle ground on health care that even the mention of healthcare causes both sides blood to boil.
The GOP will repeal ObamaCare………then they will NEVER, EVER, EVER replace it….because the PACS have bought and paid for every Republican in office…….
On this I have to agree with Jeffery…..Even Paul Ryan cant bring himself to say WALL….he says when asked about a WALL……SECURE THE BORDER….there is very little in Trumps agenda that will pass the GOP controlled congress…….Remember 90 percent of them were NEVER TRUMPERS……..
Pre-existing conditions refers to specific diseases or conditions present before insurance is purchased. The insurance companies would exclude coverage of these conditions. For example they would not cover diabetes related costs for a diabetic. Not the same as company paid insurance having a 6 or 12 month waiting period.
From a business perspective, not insuring sick people makes perfect sense, but from a social welfare perspective it had to be changed. Insurance companies much prefer collecting premiums to paying for care.
Congress critters, Big Labor unions, and Muslims exempted.
It’s only “fair”.
I am just curious Jeffery, before the ACA did your company offer to pay increased premiums for new employees with pre-existing conditions?
Did you tell your existing employees that for the “social welfare perspective,” your company was going to raise the employee rates for health care to cover the pre-existing conditions of other, new employees?
“Believe it or not, Americans like Obamacare. They just don’t know they like Obamacare.”
This. This perfectly illustrates liberal “thinking”. And this is why they lost the WH, Senate and the House.
OH NOs if they repeal Obamacare they’re going to have to give back the $700 billion they stole from Medicare. They won’t have anything left to pay for the Death Panels for the elderly, they won’t have any pain pills for them when they put them in the corner to die. Social Security will go bankrupt faster if they live longer.
Interesting survey on Americans and healthcare:
http://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-health-care-priorities-for-2017/