It might turn out better than critics expect. It might even be modestly successful. But you’ll probably never know it, because the sweeping new healthcare program known as Obamacare will have a PR problem for generations.
With the first big phase of the program due to begin October 1, when state-level exchanges offering healthcare insurance open up, we’re finally getting some details of how Obamacare will actually work, which have been sorely lacking since the scheme became law in 2010. The government says the typical monthly premium for a mid-range insurance plan under Obamacare will average about $328, depending on what state you live in. People with incomes close to the poverty line will get the best deal, as intended. Americans between 19 and 25 already seem to be taking advantage of a provision allowing them to remain on their parents’ health insurance, which has been in effect for two years and has led to a big drop in the uninsured rate for that age group.
Those are generally positive developments that will help improve people’s lives in the real world. But as The Daily Ticker's Lauren Lyster and I discuss in the video above, Obamacare horror stories could overwhelm any good news about the program, at least in the public imagination. Here are four reasons why:
For some patients, the wait to see a doctor will be interminable. We know now that some health insurers have kept premiums down for Obamacare subscribers by creating new healthcare networks that will have fewer hospitals, clinics, doctors and other caregivers than their traditional plans offer. This isn’t inherently bad, but it seems certain to generate anecdotal headlines about this or that forlorn patient who waited so long for a biopsy or stent that she died before care could be delivered. That will provide plenty of ammunition for Obamacare critics eager to declare, “See! I told you so! It’s socialism!”
Costs for some Obamacare enrollees will be high. Those likely to feel the pinch of premiums the most are people with incomes just above the threshold for subsidies (which is 400% of the poverty line) who don’t get healthcare benefits wherever they work. There will also be people who sign up for bare-bones, low-cost plans, to limit out-of-pocket expenses, but suddenly need emergency care and find that their thin policies leave them with thousands of dollars in deductibles and uncovered costs. The same thing happens now, in a system that discriminates against people who don’t get insurance through their employer. But when it happens under Obamacare, it will be incontrovertible evidence that the healthcare reform law is driving people to the poor house.
Obamacare critics are hunting for ammunition. As repeated efforts to kill Obamacare in Congress and some state capitals make clear, Republicans and others opposed to the law aren’t exactly content to sit back and let the program run its course. They’ll be hunting for horror stories and using a sophisticated publicity machine to make sure every bit of bad news reaches the largest possible audience.
Many Americans will embrace the negativity. Obamacare has been the target of a massive disinformation campaign, with polls suggesting that millions of Americans believe bogus claims about the program, such as the secret existence of “death panels” or a new tax on all homeowners that’s necessary to pay for Obamacare. That’s probably one reason disapproval of Obamacare has risen since 2010, even though only a few provisions of the law have been in effect. Once Obamacare is fully up and running, there’s no reason for detractors to stop bashing it or for gullible Americans to stop believing some of the outlandish claims.
If most of the people who sign up for Obamacare have a generally good experience, it will be harder for detractors to credibly trash the program. Most Americans will end up knowing somebody who gets healthcare coverage through Obamacare, so the word will get out fairly quickly. It will only take a few serious problems, however, to tarnish the whole program. Preventive care was never so important.
Rick Newman’s latest book is Rebounders: How Winners Pivot From Setback To Success. Follow him on Twitter: @rickjnewman.