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May 26, 2014 1:10 AM Thanks, But We Still Hate Obamacare

By Jonathan Bernstein

Greg Sargent gets a great nugget from Democratic pollster Celinda Lake, who “recently conducted a statewide poll in Kentucky for an unnamed client and found that Kynect polls very positively, in contrast to Obamacare, which is underwater.”

Kynect is the Kentucky version of the Affordable Care Act exchange. To the extent the polling is correct, these results are another example of people loving the ACA but hating Obamacare.

Which just isn’t very surprising. People still don’t really know what “Obamacare” is. Why should they? There’s nothing labeled “Obamacare” that anyone has to deal with; almost nothing labeled “Affordable Care Act;” and there aren’t even all that many noticeable parts of the new system. Of course, Kynect is one of those new things, but there’s no reason for anyone in Kentucky to know that it has anything to do with the national law.

Does this mean Obamacare eventually will become popular? No, it doesn’t. As I’ve argued, we’ve now hit or probably passed peak Obamacare awareness. I’m sure that a number of people who signed up on the exchanges this year did realize it was something new and was related to the big fuss about national health-care reform. Not all of them, and we’re only talking about 8 million or so people who signed on, but some. Next year and beyond, decreasing numbers of people will associate the exchanges with President Barack Obama and that old Washington story about “Obamacare.” Instead, the program will just be the normal way people get insurance if they’re not covered at work. It’s amazing how little time it takes for people to believe something has always been around. And, yes, that’s not even taking into account politicians who actively try to confuse the issue.

And the exchanges (for the minority who use them) continue to be the most visible, and the most branded, piece of the ACA. Look, for example, at Adrianna McIntyre’s list today of “21 things Obamacare does that you don’t know about.” To take one: it turns out that large employers that offer insurance must autoenroll with an opt-out, instead of having a default of non-enrollment. That’s potentially a big deal, but almost no one who benefits from this (or, I suppose, suffers because of it) will ever know that it’s part of the ACA.

Or here’s one that isn’t on McIntyre’s list: Everyone who has followed the health-care debate knows that Obamacare requires insurers to keep young adults on their parents’ plans until they are 26. I suspect many in the first group of people who took advantage of that provision were aware of where it came from. But five years from now, no one will know; it will just be the normal way insurance works.

Nor is there much that Democrats can do about it. It’s not a result of poor communications strategy. It’s inherent in the type of law they passed. The “nudge” provision on employer-provided insurance is an extreme example; the whole point is to avoid confronting people, so beneficiaries aren’t going to appreciate it.

All of this explains why a flat-out repeal of the ACA isn’t even remotely plausible, even if “Obamacare” remains unpopular. Repeal would suddenly take away things that people count on - not just the exchanges (and expanded Medicaid), but all sorts of other big and little stuff. Republicans would be suicidal to do that, and they won’t. And that leaves aside the technical problems with a flat-out repeal, which also make it impractical.

[Cross-posted at Bloomberg View]

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

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