Ten Miles Square

Blog

August 07, 2012 12:00 PM The Future of “Obamacare” Again

By Jonathan Bernstein

Kevin Drum had an item recently about “Obamacare” — the name of the program, not the program. He concludes:

[I]f ACA eventually becomes popular, then Obamacare will be a positive term. If it fails, then it will fade away. It’s that simple.

I’ve written about this before: I still don’t see it. There’s no specific program associated with ACA which lends itself to being called “Obamacare.” Or Affordable Care Act, for that matter. So a question for Drum: what exactly do you think will be called “Obamacare”? The exchanges? The entire health care system? The taxes on fancy private medical plans?

I think I’d say the opposite, actually. If Mitt Romney wins big and ACA is repealed, then Obamacare will be remembered, probably by that name, as a fiasco of one kind or another. If ACA survives and is implemented and basically works, then it will eventually lose its name…any name. The exchanges will be called whatever they’re called, and the various other pieces of it may have names (so we’ll have the IPAB), but most people and even most politicians won’t associate that stuff with the ACA or Obamacare. No one will think to call Medicaid expansion anything; it’ll just be how Medicaid is. No one will have a name for the subsidies, any more than we have a legislative name for the mortgage interest tax subsidy. We’ll have serious mistakes, too: people won’t remember what was ACA and what was previous policy and what was in subsequent legislation.

Mostly, a lot of what will happen, if ACA works, will be pretty invisible anyway. No one is going to realize that without “Obamacare” they would have been at risk for recission. Most people, especially after a few years, won’t realize that they once would have been denied insurance because of pre-existing conditions, especially those whose “condition” was mild. The cost-saving stuff will also be pretty invisible, in most cases.

We’ll still, of course, have political fights about health care, but I doubt that it will be in anyone’s interest to characterize the future system, again assuming for now that ACA is fully implemented, as created by one law. As, of course, it won’t be, anyway.

[Cross-posted at A plain blog about politics]

Jonathan Bernstein is a political scientist who writes about American politics, especially the presidency, Congress, parties, and elections.