John Boehner is right. Yesterday, in a clip played 'round the Interwebs, the former Speaker of the House and well-tanned Congressman scoffed at the notion that his fellow Republicans would shoot and bury the Affordable Care Act, as they've long promised. "I shouldn’t have called it repeal and replace because that's not what's going to happen," said Boehner at the giant annual confab of the Healthcare Information and Management Systems Society. "They’re basically going to fix the flaws and put a more conservative box around it."
To repeat: No tearing down the old house. Forget about that new neighbor-riling McMansion. (Who needs that kind of space anyway?) Let's just do a modest rehab with a fresh coat of red-state paint.
I predicted the same at the start of the year in this newsletter (see "My Crystal Ball Reading for Obamacare").
And the reasons are straightforward, if not simple.
1) Americans like--indeed, really like--the core elements of the ACA. They just haven't liked the name so much. And you know what? Increasingly, people are even starting to like the name, too. The latest poll from the respected nonpartisan Pew Research Center shows that 54% of U.S. adults approve of the former president's health care law, while 43% remain against it--a shift toward favorability that has been largely echoed in other recent polls.
2) People don't like it when you take something away from them, even if they're not 100% happy with the thing you took. You may hate how sluggish the transmission is on your 2010 Camry and feel like your gas mileage is half what it should be--but you'd still be cursing to the hilltops if the car got impounded or stolen...or even gently bumped in the supermarket parking lot. In a month, the ACA will turn seven years old. That's long enough to get used to the thing, blemishes and all.
3) The people that are most used to Obamacare--and I use "people" here in the sense of Citizens United vs. Federal Election Commission--are the healthcare providers, insurers, and hospital systems who are deeply embedded in it. Go ahead, ask any of these "folks" if they want a full-out repeal. I've been asking around and I have yet to find a single ACA-entwined player who wants to throw it out and start all over again.
4) Republican lawmakers may dismiss the recent angry town halls in their home districts as the work of outside agitators--but they're afraid of them (no matter what the party leadership says).
And then there's this--which ex-Speaker Boehner told his audience yesterday as well:
5) "In the 25 years that I served in the United States Congress, Republicans never, ever one time agreed on what a healthcare proposal should look like. Not once."
As Boehner concluded, "Most of the Affordable Care Act, the framework, is going to stay there."
Yes, my friends, it will. How the new Congress and Administration spin that is anybody's guess.
Enjoy your well-deserved weekend.
This essay appears in today’s edition of the Fortune Brainstorm Health Daily. Get it delivered straight to your inbox.
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