Obamacare, Public Opinion, and Conservative Self-Delusion
By Jonathan Chait, New York, 06/13/2013
One of the more important conservative beliefs about Obamacare, running right alongside the certainty that the law is a disaster that will fail in every respect, is the belief that Americans share their antipathy to the law. It certainly is true that the Affordable Care Act has a bad reputation, and the latest poll showing that support for Obamacare has dipped prompted the same wave of conservative gloating that results from every such poll. But looking even an inch beneath the surface reveals a public more frustrated and confused by Obamacare than opposed. Its specific elements poll well, though they’re the least known elements. Four out of ten Americans don’t realize the law hasn’t been struck down. A new poll out shows that the public, by a ten-point margin, trusts Democrats over Republicans on health-care issues. By a 52–34 percent margin, they want Congress to implement or tinker with the law rather than repeal it. The nearly ubiquitous conservative belief that the public shares its passion for repealing Obamacare is a spate of self-delusion.
That overconfident delusion is the subject of Ramesh Ponnuru’s long National Review essay pleading with conservatives to stop believing their own #$%$. Ponnuru faithfully affirms the general outlines of the right-wing case: Of course the law is terrible, of course it won’t work, of course it must be repealed. He even repeats the misleading line that Max Baucus warned the law would be a "train wreck." But Ponnuru gently warns that the failure might be slow to arrive, and perhaps not the Greece-esque national catastrophe conservatives have talked themselves into expecting. His account of what conservatives expect to happen, furnished from within the movement, is actually frightening:
A few conservative lawmakers have speculated that the law will crash so badly that the Democrats will themselves demand repeal in the next couple of years.
A few Republicans who believe that these effects should not be put off: that Americans should suffer them so as to see the failure of Obamacare with their own eyes. Only then will they turn against the law and its supporters with the requisite passion to undo it.
Ponnuru argues that Republicans must also get serious, finally, about replacing the law with something other than the status quo. But there’s a reason Republicans don’t make repealing Obamacare contingent on an alternative plan: Alternative plans that do anything are hard. People get attached to what they have and suspicious of change. Republicans killed Bill Clinton’s health reform by raising the specter that people who have insurance would get something different, which they didn’t trust. The GOP’s only real health-care traction in the 2012 elections came by assailing Obama for cutting Medicare.
Republicans have wisely decided to attack Obamacare without committing themselves to an alternative because the alternative would be easy to attack. Ponnuru, for instance, suggests changing the tax code and stripping regulations to create “a market in which almost everyone would be able to purchase relatively cheap, renewable insurance policies that protected them from the risk of catastrophic health expenses.” Telling tens of millions of Americans they’ll lose their insurance that covers basic medical expenses and get bare-bones policies with thousands of dollars in deductibles is not a winning play.
The Republican war against the implementation of Obamacare is largely an attempt to exploit Amercians’ aversions to change. That’s why the GOP is throwing around wild, inflated claims of “rate shock” — sowing fears that Obamacare will jack up peoples’ health-insurance premiums. The latest party organ to do this is the Republican leadership in Ohio, which is warning its citizens that they will face enormous new costs. (Jonathan Cohn takes apart the shoddy claims.)
The tiny kernel of truth is that a handful of people — mostly young, male, and healthy — will have to buy into some kind of regular insurance plan that covers stuff, not only plans that cover your costs if you’re injured in a car crash and make you pay for just about everything else. The scare campaign could work, at least to some extent. But if it works, it won’t work because Americans are dying to be converted to an all-catastrophic, high-deductible system.
What Republicans have going for them is that health care is really complicated, people don’t spend hours a day boning up on public policy, and those who have insurance understandably fear losing what they have. But the vast majority of the public is not going to see any changes under the new law. Even if the Obamacare exchanges collapse, they only bring in people who don’t have Medicare or employer coverage anyway and are already suffering through a dysfunctional individual insurance market. The “shock” is going to be felt by conservatives who are expecting their Randian fantasies of socialist dystopia to come true.
Sentiment: Strong Buy
Sorry elk, but you and Mr. Ponnuru are living in a dream world. Public disillusion with Obamacare will set in after it becomes effective. Why do you think so many people want to be exempted, including unions and politicians, or want to opt out? Wait and see. Reality will set in when you see the doctor shortage, long waiting lines, rationing off care, and above all the excessive cost. Then, and only then will you guys get some vision and see the light.
The reality is that everyone is going to be in for a rude awakening and shock when they pay out the nose and not get shiet, you will not likey see a doctor and wait in line for months to see ie a cardiologist or any other specialist,,
Just last week,, WV medicaid requires the doctor to fill out a 10 page report just to get a CT scan,, well guess what,, thats not going to happen in my office so all those needing CT are just going to have to go to a federally funded clinic where they can take the time to fill out a stupid fkin report,, its gaddam terrible what Obamacare is bringing,, people are going to fall through the cracks and many will die for lack of care,, you just wait,, the pain is coming,,
I hear you Doc,
I was reading an article the other day where Europe is in an uproar over their medical care due to having to wait countless hours just to be able to fill out a report to make an appointment to be seen weeks later........The premise that Obama care will not follow this pattern is a no brainer, as it will.....
For most of the pups on this MB they don't care right now because they are still young and letting Uncle Sam take care of their bills.....You can tell by their banter on the MB......However, when they become old and ill then they will be whining even more than they currently do......Of course they can always run to Papa Obama for help.........
Sentiment: Strong Buy
ARIZONA MEDICAID EXPANSION ADVANCES AFTER JAN BREWER FORCES LAWMAKERS' HANDS
Arizona will expand Medicaid to cover nearly 300,000 poor residents next year after a bipartisan coalition passed a measure backed by Gov. Jan Brewer (R) through the state legislature on Thursday.
Brewer, a conservative and avowed foe of President Barack Obama's health care reform law, announced her support for the Medicaid expansion in January, but faced stiff resistance from fellow Republicans in Arizona's House and Senate. During a marathon session that began Wednesday afternoon and stretched into the wee hours of Thursday morning before culminating in a final vote late Thursday afternoon, a handful of Republicans joined Democrats in the House and Senate to pass the Medicaid expansion.
Although Obama's health care law continues to divide elected officials and the public along starkly partisan lines, Brewer is one of nine Republican governors who have bucked their party and embraced the Medicaid expansion.
The Arizona governor has aggressively promoted the measure since taking her surprising public stand earlier this year. Brewer assembled a coalition of health care interests and business groups and worked alongside Democratic legislators in addition to campaigning across the state in service of extending health coverage to hundreds of thousands of poor Arizonans using Obamacare funding.
Brewer played hardball with Republican legislative leaders in the state to get her way, earning their ire in the process. She followed through on her threat to veto any bill not addressing the Medicaid expansion last month. On Tuesday, she raised the stakes by calling a special session and forcing the temporarily adjourned legislature back to work on Medicaid and the state's budget.
Republican legislative leaders and conservative lawmakers have bristled at Brewer's embrace of the expansion, a key component of Obamacare, and objected to her calling a special session when the legislature was schedule to reconvene later in the week anyway.
Brewer won praise from conservatives for her hardline stance against illegal immigration, but she has attracted strong right-wing condemnation over Medicaid.
The political fallout from the spilt among Arizona Republicans won't have an immediate effect on Brewer's electoral future: She can't seek another four years as governor when her time runs out next year because of state term limits. She ascended from Arizona secretary of state to the governor's office when Obama tapped then-Gov. Janet Napolitano (D) to be his secretary of homeland security in 2009; voters reelected Brewer in 2010.
Arizona is among the 29 states and the District of Columbia with chief executives who support expanding Medicaid under Obamacare to anyone who earns less than 133 percent of the federal poverty level, which is $15,282 for a single person this year. Majority-Republican legislatures in a number of states have stymied expansions endorsed by their governors, including Florida's Rick Scott (R), Ohio's John Kasich (R), Michigan's Rick Snyder (R), Missouri's Jay Nixon (D) and others.
"This is a big deal because Arizona and Gov. Brewer are very conservative," said Ron Pollack, executive director of Families USA, a consumer advocacy organization that supports the health care reform law. "It shows that at least for this governor and this state, practicality and common sense has prevailed over ideology and partisanship," ………………..
Sentiment: Strong Buy