Political Animal


June 20, 2012 9:56 AM The Abiding Majority For Health Care Reform

By Ed Kilgore

There’s no question the conventional wisdom among all Republicans, most MSM “observers,” and quite a few Democrats is that the Patient Protection and Affordable Care Act of 2010 represented an “overreach” by the Obama administration, and/or a fatal distraction from the really significant economic challenges it faced. In other words, Obama should have waited for a more propitious moment, at the very least.

It’s interesting, then, what a new AP-GfK survey shows the American people think should happen if ObamaCare is invalidated by the Supreme Court:

If the Supreme Court rules that the health care reforms passed in March 2010 are unconstitutional, what do you think the President and Congress should do about the health care system?

19% said “leave the health care system as it is,” and 77% said “start work on a new health care reform bill.”

That’s not surprising when you think about it. Of the 40-60% of Americans who express opposition to “ObamaCare” in one form or another, probably a fourth oppose it because it’s not single payer, and half the rest support all the individual components of ACA but either don’t understand it, don’t trust the government to implement it correctly, and/or have bought some of the big lies about it like the “death panel” smear.

That’s why I’d bet quite a few Republican pols secretly hope the Court leaves ObamaCare alone. Aside from giving them a hobgoblin to rattle, that development would avoid the fateful day when the public begins to understand ACA more accurately, and Republicans have to (a) figure out what kind of health care reforms they can support as a party now that they’ve demonized so much of their own past thinking (i.e., the individual mandate), and (b) get some real scrutiny for such shabby “reforms” as interstate health insurance sales, which sound fine until you think hard for a few moments about how they’d actually work.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.


  • J on June 20, 2012 10:07 AM:

    Agree with your comments, it rankles me when people say they do not know what is in the affordable care act, I feel like I know most of what is in it and I have not been concentrating. I read it online a couple of years ago and seem to remember a paragraph stating that any state who could could up with a better and affordable solution for the states people could apply to opt out.Does anyone know what's going on with that, I know Vermont is going for single payer.When the republicans took the house in the mid-terms with their repeal and replace talk I wrote to mmy repub representative and asked for details of the 'replace'
    his answer was that the committees were working on it and would soon publish it.Needless to say I have not heard a thing and he was lying.

  • stormskies on June 20, 2012 10:21 AM:

    I agree with J regards the American people not yet 'knowing' what's in the ACT. That's because, of course, most don't really bother to read, listen, or study these things. Another hamburger and some stupid TV show is vastly more important.

    Let's remember too and very important part of this ACT is the fact that due to the efforts of Senator Sanders over 15 billion dollars is dedicated to expanding the local community health car clinics around our country. That includes money for the full staffing of doctors and nurses. This is what allows low income people to visit a doctor because it's based on a sliding income scale. And, of course, the corporate media ignores this critical component of the ACA.

    Also, another story totally snuffed by the corporate media, is the fact that Congressman Jim McDermott of Washington State has introduced legislation that would allow all the states to use federal money to establish their own single payer system. Never heard of this ? Why not ?

    And, yes, the ACA does allow the states to back out if they do indeed produce a better idea.

  • Ron Byers on June 20, 2012 10:21 AM:

    This is 2012, not 2008-2009. I know lots more about the ACA than I did when it was passed. So does anybody else who makes healthcare purchase decisions. I like what I have seen so far. My employees are very happy. I think that repealing the ACA is going to be a disaster and a lot of people are going to be screaming. I think the Republicans should be aware of what they are wishing for, and what the are wishing for in repealing the ACA is going to be single payer.

    We need to educate the great unwashed media about how important the various features of the ACA are to all of us. I think the media and a lot of Federal employees are absolutely clueless about what is in bill.

  • delNorte on June 20, 2012 10:37 AM:

    It will be interesting to see what happens if The Court overturns the individual mandate, but keeps the rest of ACA intact. Private insurance companies would be crushed by that outcome, because people could wait until they got sick to sign up for health insurance.

    The solution, if The Court so decides, would have to come through some new legislation (such as having an open enrollment period to sign up for insurance, and if you don't, you don't get the chance to enroll for another year or two - the individual then reaps the results of their own decision, rather than being compelled by the government to act) - but, is the current legislature even able to legislate?

    The individual mandate doesn't kick in till 2014, so the next congress could deal with the fallout.

    If The Court overturns the entire ACA legislation, then much crap will hit the fan, much of it unforseen and unknown at this point.

  • c u n d gulag on June 20, 2012 10:40 AM:

    A person would have to be a feckin' idjit, or a Conservative (but I repeat myself,) if they're happy with the system the way it is now.

    Every one else knows that they system is completely broken.

    They know, because even if people DO get a raise at the end of the year, it's immediately gobbled-up by a still greater increase in their employee contribution to the companies health care plan - and THAT'S for the people who ARE working, and HAVE employer-provided health care.

    Individual policies are virtually unaffordable to all but the wealthiest people and their families.

    And the fight for "Inter-state" polices amongst states could be interesting.
    Which state will be the lowest common denominator for all of the others?

    Whichever state it is, the other 49 ought to rename it "Anarchy," because it will immediately help to wipe-out any states minimum standards.

    Let's face it, when feckin' Conservative idjits talk about "State's Rights," what they mean is a state's right to its own racism, misogyny, xenophobia, and homophobia.

  • T2 on June 20, 2012 10:48 AM:

    The three main causes of the Deficit ( which Conservatives now demand must be eliminated although it was fine under Bush) are 1-Bush's Wars, 2-Bush's Tax Cuts for Rich, 3-Healthcare.

    Obama's goals with ACA were 1)reduce costs and in turn, the Deficit, 2-help Americans have affordable healthcare.

    Sounds good to me. Sounds terrible to Conservatives. If the SC guts ACA, we'll find out who is right and who is wrong.

  • bdop4 on June 20, 2012 11:01 AM:

    Count me as one of those disappointed that single payer didn't even get a SEAT AT THE TABLE. A part of me also sees repeal as an opportunity to implement single payer.

    But to repeal and do nothing? Ain't going to happen.

    Conservatives better be careful what they wish for.

  • boatboy_srq on June 20, 2012 11:22 AM:

    It would be interesting to see what would happen if all the Teahadists, convinced that the ACA only made things better for Teh Other, suddenly got their benefits reexamined - and shrunk - following a SCOTUS smackdown of ACA and another round of God's Own Party's "austerity." I'd bet all those volk "blessed" with good health (thanks to Medicare and lots of prescription meds - and let's not forget to include Viagra in those meds) will suddenly find their health isn't such a "blessing" after all. It's tempting to look them in the eye and say, "The last time we tried to fix this for you, you whinged about the fix being 'socialism' and riddled with 'gubmint overreach,' 'death panels' and the like. Since you don't want all that, there's nothing left we can do that isn't further along the path you insist is wrong; go home and count your 'blessings.'"

    While I really hope the ACA survives intact, I can't help thinking that it would be good for the Reichwing to kill this off and see how well their followers do in the aftermath. Perhaps then we can relegate the fascist shriekers to the corner-stool-and-duncecap they merit - and get back to something resembling reasonable government.

  • jjm on June 20, 2012 12:30 PM:

    Too bad the dumb cluck voters who have repeatedly polled as HATING ACA really only want another shot at a health care bill (because when polled on its features, they love them).

    Do they think if this law is shot down by the Court that ANY Congress or ANY president would touch health care again with a ten foot pole?

    That was your shot, folks. If you'd kept it, it could have been amended or expanded.

    But if it's overturned you will NEVER get another chance -- it would be a toxic topic never to be mentioned by any politician ever again.

  • JR on June 20, 2012 4:22 PM:

    I have a hard time understanding how so many can claim ignorance/opposition because I can't believe they don't know someone who's been affected.

    My best friend discovered the hard way who were the true death panels: the insurance industry. After losing her most-excellent HR position with a major global firm, she considered herself lucky to land a sales floor gig with a national home decor chain. Sure, she went from about $100K/year with great benefits to $10/hour with no benefits, but it was a job. She didn't complain; she felt lucky. The crap hit the fan when her COBRA ran out, and no one would insure a 10-year-cancer-free breast cancer survivor. Only after the ACA was enacted could she obtain insurance (albeit at $700/month with a very high deductible).

    I also don't understand why more Americans aren't appalled at GOP desire to leave it to the free market. Anyone who has a cable or phone bill know what that means. Personally, I'm old enough to remember when the Baby Bells were consolidated. We were then told that it was a good thing. Rates were sure to go down. No, it meant competition was killed and the phone companies could charge us whatever they damn pleased!

  • Jerry Policoff on June 20, 2012 4:29 PM:

    First some clarifications:

    The McDermott bill has been temporarily withdrawn. It was leaked to the LA Times, and McDermott probably got some major blow back for it, mostly from Democrats. Hopefully it will be back.

    State waivers that would, in theory, allow states to experiment, including with single-payer, do not take effect until 2017. There are efforts afoot to move that date up to 2014, and Obama has endorsed that, but no one seems to be pushing it too hard. Besides, absent state ERISA waivers the insurance companies would probably try to block single-payer efforts in the courts even though they would seem not to violate ERISA.

    The problem with the ACA is that it equates having health insurance with having access to health care, and those are two very different things. Many of the newly insured will have expensive premiums plus large deductibles and co-pays. That will make it difficult for many to see a doctor when they get sick. This is called being under insured, and it is almost as bad as being uninsured.

    The other major problem is that the gatekeepers of the system remain the for-profit insurance companies, and they will continue to deny needed care whenever possible because that is how they maximize profits.

    This is a revealing poll. The American people want healthcare reform, but they don't much care for the ACA. I think they do know what is in the bill, and they don't care for it.

    The answer is single-payer.

  • boatboy_srq on June 20, 2012 4:57 PM:

    @Jerry Policoff:

    You may well be right that the US' citizenry doesn't care much for the ACA because it doesn't do enough, and gives away too much to companies already profitable in the current system.

    If that were the case, however, the noise wouldn't be about repealing it because it's "socialist, "government intervention" or "infringement on religious liberty." It would instead be about "copays," "deductibles" and "exclusions" just as you mention.

    What you say may be true. And given how the MSM folds the "it doesn't go far enough" nays in with the "it's big gubmint intrusion" nays, it's hard to gauge just from the oversimplified reporting on the polling. But what you suggest isn't borne out by the whinging of the Reichwing, or the ugly anti-ACA noise coming from most of the GOP.

  • Jerry Policoff on June 20, 2012 5:48 PM:


    The GOP opposes ACA for all the wrong reasons, and also because they will oppose anything Obama favors. Don't forget this is basically a Republican plan that was originally proposed by the Heritage Foundation and enacted by Mitt Romney in Massachusetts.

    The poll speaks for itself. ACA attracts minimal support, but 77% want healthcare reform.

    Insurance companies have been shifting more and more of the cost of healthcare to their customers for several years now, and the proof that their intent is being realized is that healthcare utilization keeps dropping. Poll after poll reveals that a large percentage of the public is opting not to see a doctor when sick and/or is cutting back or doing without prescribed medication. I think the evidence strongly backs up my original premise. The fact that the right wingers don't like the ACA doesn't ipso fact mean that it is a good thing. Even a broken clock is right twice a day.

  • boatboy_srq on June 20, 2012 10:35 PM:

    @Jerry Policoff:

    Please stop putting words in my mouth. I never said I like the ACA. But given the Reichwing's whinging all the way down, it seems like the least bad thing we can get. There's a lot of that in society. Most US citizens probably don't enjoy driving to work all that much, but unemployment sucks a whole lot worse than traffic, fuel bills and monthly parking fees; that doesn't make driving to work good, just less bad than the alternative.

    The polling, as reported, doesn't tell us enough about why the citizens don't like the ACA. And the MSM is very good at parroting GOP talking points, and pointing out that dislike/dissatisfaction with ACA means that striking it down will be a good thing. Nobody talks about the "replace" part of RnR from the left, and the Reichwing hasn't provided any hint that a replacement that doesn't either beggar Medicare/Medicaid or preserve the current geometric inflation in medical expenses. There may be a valid replacement strategy besides single payer for progressives to get behind, but without anyone proposing it from any position of authority, all we're left with is GOP sugar-plums dancing in the heads of the insurance industry.

    I'm not forgetting the ACA is very little different from what Gingrich's Congress proposed as a counter to the Clinton healthcare plan back in 1993-4. McConnell, among other very loud detractors of the ACA, was there for the 1990s plan and supported the idea as late as 2009. But I also remember that they were all for it - until Obama agreed that it was probably the choice most likely to succeed. I get the feeling that no matter how far any Democrat (especially Obama) moves to the right, God's Own Party will stake out territory geometrically farther along that continuum; indeed, if he'd suggested that we euthanize the poor and sick, I'd expect the GOP to clamor for them to be ground up alive and served as part of the school lunch program, and anything less severe would be just cause for a new Revolution complete with muskets and M-16s.

    None of that tendency is likely to go away any time soon no matter how SCOTUS decides, and the wingnuts will be able to spin that as majority support for doing away with necessary parts of the program just because they're unpopular. The majority doesn't set policy anymore: just the loudest voices; all it took was Donohue, Dolan and a handful of AoG congregations and suddenly "religious liberty" is now a buzzword on the Right and a policy problem for ACA which means to cover everyone but can't because some religious wingnuts won't allow it. This is a few thousand people negatively impacting what medical coverage will be available for over 300 million; take some other aspect of the ACA unpopular among the Wingnuts and you'll find a similar trend. No poll is going to make a dent in that.

    jjm is right: bad as it is, the ACA is probably the last hope the US has for rational healthcare insurance for a generation. I'm glad somebody among us lives in some federalist utopia where the states can use the opt-out clauses in the ACA to deliver better solutions; after ten years' worth of living in red states where the prevailing opinion is that absolutely anyone is worth screwing so the 1% get their take increased because they're Elect and they deserve it (oh and TABMITWH so anything to stop him is just and righteous and hunky-dory, no matter who gets hurt,) I'm just not that sanguine.

    And I'm not arguing with you over the options on the table - but about how "revealing" the poll is - especially when a majority of the populace will never see the details and only get the "most people oppose the ACA" part. If the poll is "revealing" then you might tell us why without suggesting that we here don't do our own homework.

  • CharlieE on June 20, 2012 10:53 PM:

    Personally, I'm old enough to remember when the Baby Bells were consolidated. We were then told that it was a good thing. Rates were sure to go down.

    If you're old enough to remember when the Baby Bells were consolidated, then you're old enough to remember that long distance calls at that time cost about 25 cents per minute.

    Back then, my phone bill consisted mostly of long distance toll charges that almost always exceeded the monthly charge for the line itself. I can't speak for you, but I no longer pay anything at all for long distance calls.

    Rates have gone down.

  • Garth Bebout on June 20, 2012 11:11 PM:

    Anything to slow him down. It's almost July. This was his "big accomplishment" aside from "The Beer Summit." This ego needs to be deflated. I want a President who I won't see on "The View"

  • Garth Bebout on June 20, 2012 11:46 PM:

    Why the interest in gays and marriage? I suspect he's getting spoiled being cruised by rooms full of hungry men. If this happens this will be viewed as his most catastrophic mistake. This isn't Canada. Innocent lives could be in jeopardy in the U.S. over this late '90's pipe dream-- bought, sold and "equal." If for no other reason, I would vote for Romney over this issue. I've always been a gay liberal Democrat, but this seems based on a self-entitled generation. Thank God most of my gay life happened in the 20th Century. Odd how marriage was not on our minds such a short time ago. We were such an "oppressed minority" how did we manage?