A Conundrum: Majority Of Republican Voters Want To Overturn Aca But Keep Protections For People With Pre
The latest KFF Health Tracking Poll revealed a stark contrast in opinion on two questions about the current challenge to the Affordable Care Act facing the U.S. Supreme Court. Since it was enacted in 2010 by President Obama, the ACA, sometimes known as Obamacare, has been opposed by Republicans and favored by Democrats, but many of the benefits it provides are popular across parties. One of the most popular provisions of the law is that it protects people with pre-existing medical conditions from being denied coverage or having to pay more for coverage. A large majority of voters, across political party identification, say they do not want the Court to overturn the ACA’s protections for people with pre-existing conditions, but there are strong partisan differences on attitudes towards overturning the entire ACA. Two-thirds of Republican voters say they do not want the ACA’s protections for people with pre-existing conditions to be overturned, while three-quarters of Republican voters say they do want to see the ACA itself overturned.
Figure 1: Majorities Do Not Want Court To Overturn ACA’s Pre-Existing Condition Protections, Republicans Want Entire Law Overturned
Figure 2: About Half Of Republican Voters Want To See The Supreme Court Overturn The Entire ACA, Not Protections For Pre-Existing Conditions
Figure 3: Republican Voters Say President Trump Has A Plan To Protect People With Pre-Existing Conditions
Heres An Interesting Theory About Why Republicans Hate Obamacare Theyre Scared People Will Like It
One of the big mysteries about the government shutdown is why Republicans are so furiously opposed to the Affordable Care Act, a.k.a., Obamacare.
Yes, the Act has many problems, not the least of which are its high costs and mind-boggling complexity.
But the Act’s overall goal, which seems achievable, is to make health insurance more affordable for tens of millions of Americans. And although one can be frustrated about some details, it seems strange that this should cause a party to rage and howl and shut down the government.
So why are the Republicans so outraged about Obamacare?
There are different theories.
The Republicans themselves say that Obamacare will destroy the country. They rarely explain that assertion, though, so it’s hard to know what they actually mean.
They say that Obamacare will destroy the economy, by forcing businesses to spend more on health care costs and compliance and, in some cases, by hiring part-time workers instead of full-time ones. This may be true at the margin, but companies have long been spending more on health care and reducing health care benefits for their employees while shifting more of the costs onto them. But the truth is that, for most companies, Obamacare just isn’t that big a deal. I run a company, and that’s the way I would characterise it: It’s a little deal but not a big deal. It’s not going to cause us to change our hiring plans or fire anyone.
Outside the Republican Party, there are different theories.
Why Do Republicans Want To Repeal Obamacare So Much Because It Would Be A Big Tax Cut For The Rich
There are going to be so many tax cuts for the rich, you’re going to get tired of tax cuts for the rich. You’re going to say, “Mr. President, please don’t cut taxes for the rich so much, this is getting terrible.”
And it will start when Republicans repeal Obamacare.
This is the Rosetta Stone for understanding why conservatives have acted like subsidized health care was the end of the republic itself. It wasn’t just that it had the word “Obama” in its name, which, in our polarized age, was enough to ensure that 45 percent of the country would despise it. No, it was that Obamacare was one of the biggest redistributive policies of the last 50 years. The Republican Party, after all, exists for what seems like the sole purpose of reversing redistribution.
A quick recap: Obamacare is a kind of three-legged stool. First, it tells insurance companies that they can’t discriminate against sick people anymore; second, it tells people that they have to buy insurance or pay a penalty, so that everyone doesn’t just wait until they’re sick to get covered; and third, it helps people who can’t afford the plans they have to buy be able to. Which is to say that you need to come up with a whole lot of money to make this work — money that Obamacare gets by taxing the rich. Indeed, at its most basic level, it raises taxes on the top 1 percent to pay for health insurance for the bottom 40 percent.
Getting tired of tax cuts for the rich yet?
For The Third Time The Supreme Court Rejected A Challenge To A Law Opposed By Most Republicans
Supporters of the Affordable Care Act demonstrated in front of the U.S. Supreme Court in Washington, D.C., last year.
The Supreme Court turned back the latest challenge to the Affordable Care Act, leaving the healthcare law known as Obamacare in place. Here is a look at the law and the views of its supporters and detractors.
What is the Affordable Care Act?
The Affordable Care Act was passed by a Democratic-controlled Congress and signed into law by then-President Barack Obama in 2010, and has had . The law expanded eligibility for Medicaid, though about a dozen states have still not adopted the change. It created online marketplaces where consumers could get plans from insurers, and a system of federal subsidies that help most enrollees pay for the coverage. Under a law that passed this March, eligibility for the subsidies expanded to include more people.
The ACA also rewrote the rules around insurance. Because of the law, insurers can no longer deny coverage or charge more for plans based on a person’s pre-existing health conditions. They can’t cap the amount they pay out in benefits. Also, they have to spend a set share of the premiums they receive on healthcare-related costs, limiting the portion that goes to profits and administration.
What do the ACA’s backers say about it?
Republicans Are Still Trying To Repeal Obamacare Heres Why They Are Not Likely To Succeed
Conservatives are still trying to repeal the Affordable Care Act — even after the Republican-majority Congress failed to overturn the law in 2017. A coalition of conservative groups intends to release a new plan this summer. The groups will reportedly propose ending the law’s expansion of Medicaid and convert Medicaid funding into block grants to the states. And just last week the Trump administration’s Justice Department argued in a legal filing that key provisions of the law — its protections for persons with preexisting conditions — are unconstitutional.
Why are Republicans still trying to undo the ACA? We argue in a forthcoming article that the law’s political vulnerabilities and Republican electoral dynamics drive conservative efforts to uproot it.
In the past, conservatives have thrown in the towel
As politicians and political scientists both know, the can never be taken for granted. Even so, the duration and intensity of conservative resistance to the ACA is historically unusual. The ACA is a moderate law, modeled on ideas that Republicans once supported, such as insurance purchasing pools. What’s more, many red states refuse to accept the ACA’s funding to expand Medicaid to more of their citizens — such as Texas, which has a large number of uninsured residents — even though you would think they would want those federal benefits.
So why is the ACA still politically vulnerable?
The answer lies partly in the way the program was designed.
Is repeal likely?
Actual Events That Occurred As A Result Of The Affordable Care Act 2011 To 2014
- January, 2011: In 2011, insurance companies had to ensure the value for premium payments. If insurance companies did not spend at least 80% to 85% of premiums on care the difference is sent to customers in a refund.
- January 2011: A Florida judge rules that elements of the Affordable Care Act are unconstitutional.
- November 14, 2011: The US Supreme Court agrees to hear arguments in the Obamacare case brought by 26 states and the National Federation of Independent Business. It argues that elements of the Affordable Care Act are unconstitutional.
- January, 2014: Health Affairs published its most recent analysis of Medical Loss Ratio performance by major insurers.
- March, 2014: The New York Times reports that the U.S. Census Bureau, the authoritative source of health insurance data changed its annual survey so thoroughly that it became difficult to measure the effects of President Obama’s health care law.
The Health 202: Why Republicans Don’t Talk About Repealing Obamacare Anymore
Michigan Rep. Mike Bishop’s campaign website doesn’t mention Obamacare, even though Web archives show it once prominently featured promises to vigorously fight the 2010 health-care law.
Rep. Andy Barr of Kentucky touted repealing the Affordable Care Act as one of three top priorities when first running for Congress in 2012. Now his website focuses on tax cuts and job creation instead.
In her first House bid in 2014, Virginia Rep. Barbara Comstock said her campaign was about growing the economy, creating jobs and “repealing and replacing Obamacare.” She’s not talking about that anymore.
For the first time in nearly a decade, these Republican candidates and others across the country find themselves bereft of what was once their favorite talking point: repealing and replacing President Obama’s Affordable Care Act — and all the havoc they alleged it wreaked.
That’s because the GOP failed dramatically in its efforts last year to roll back the ACA as its first big legislative delivery on the promise of single-party control of Washington from Congress to the White House. That defeat has quickly turned attacks on Obamacare from centerpiece into pariah on the campaign trail, a sudden disappearing act that Democrats are looking to exploit as they seek to regain power in the midterms.
“Yeah, we probably can’t talk credibly about repeal and replace anymore,” Rep. Tom MacArthur told me a few weeks ago.
AHH, OOF and OUCHHEALTH ON THE HILLOPIOID OPTICS
Why Republicans Could Never Tell Their Voters The Truth About Obamacare
When the Supreme Court landed its latest, and possibly last, legal defeat to right-wing opponents of Obamacare, the immediate response on the right was, oddly enough, to mock the liberals who warned that the lawsuit might succeed. Conservative lawyers circulated lists of liberals who predicted that Amy Coney Barrett would side with the plaintiffs; National Review turned that list into its lead story. “They lied, lied, lied,” cries Senator Charles Grassley.
I never believed the most recent lawsuit stood much of a chance. The court’s conservatives, after some wavering, decided the first lawsuit intended to destroy Obamacare was too silly to risk their reputational capital on. The second, even sillier lawsuit lost by a wider margin. It stood to reason that the third lawsuit, the silliest one yet, would probably lose, even though conservatives had gained an additional seat.
It is probably fair to mock hand-wringing liberals for being so apocalyptically pessimistic that they thought five Supreme Court justices would side with an utterly farcical lawsuit. But perhaps this is not the only, or the most important, implication of the ruling.
The answer is that the passage of Obamacare was a traumatic event for Republicans. The wound it opened in the party’s psyche has not fully healed, and even more than a decade after its passage into law, they cannot reconcile themselves to its legitimacy.
Here Is What Republicans And Democrats Don’t Understand About Obamacare
When it comes to Obamacare and health insurance reform both Democrats and Republicans have a lot to learn.
Obamacare guaranteed people that they would never again be turned down for health insurance because of a preexisting condition. The law assured those who couldn’t afford to buy health insurance they would be given financial assistance. And, it offered the expansion of Medicaid to the poorest.
Obamacare offered health insurance security at least, it turned out, to those with the lowest incomes.
But Obamacare also clobbered the unsubsidized the individual health insurance market with its prohibitively high prices and out-of-pocket costs for the middle-class.
All across the nation, one Democrat after another ran effective ads promising to protect Obamacare and its preexisting condition reforms from those Republicans who had voted to repeal the law.
The ads resonated even though Obamacare has continued to devastate the individual health insurance market:
- In March of 2016, there were 20.2 million people covered in the individual health insurance market according to a hard count of state insurance department filings done by Mark Farrah and Associates.
- In March of 2017 that count was down to 17.7 million.
- In March of 2018 the count was 15.7 million–a 22% drop in two years.
This means 4.5 million fewer people had individual health insurance in just two years. Now the economy is strong enabling more people to join employer plans–but not that strong.
Don’t Like Obamacare It Was The Republicans’ Idea Says Liberal Democrat
Robert Reich served as Labor Secretary for President Bill Clinton.
“While Republicans plot new ways to sabotage the Affordable Care Act, it’s easy to forget that for years they’ve been arguing that any comprehensive health insurance system be designed exactly like the one that officially began October 1st, glitches and all,” said Robert Reich, who served as President Bill Clinton’s Labor Secretary.
Reich says Democrats should have insisted on a single-payer system because it would have been “cheaper, simpler, and more popular.”
In a blog at The Huffington Post website, Reich wrote that Republicans have long argued for a health care system based on private insurance and paid for with subsidies and a requirement that the young and healthy people sign up. Democrats, he says, wanted to model health care reform on Social Security and Medicare, and fund it through the payroll tax.
Reich says President Richard Nixon in 1974, “proposed, in essence, today’s Affordable Care Act.” Thirty years later, then-Massachusetts Gov. Mitt Romney, another Republican, “made Nixon’s plan the law in Massachusetts.”
Reich adds: “When today’s Republicans rage against the individual mandate in the Affordable Care Act, it’s useful to recall this was their idea as well,” as proposed in 1989 by Stuart M. Butler of the Heritage Foundation.
Reich’s blog is entitled, “The Democrat’s Version of Health Insurance Would Have Been Cheaper, Simpler, and More Popular “
Repeal And Replace Is Dead Republicans Cant Figure Out What Comes Next
The pandemic and Biden’s incremental policies have scrambled the party’s usual lines of attack.
A demonstrator holds a sign in front of the U.S. Supreme Court as arguments are heard about the Affordable Care Act on Nov. 10, 2020. | Alex Brandon/AP Photo
02/26/2021 04:30 AM EST
Former President Donald Trump is gone and so are his promises to throw out Obamacare. Now the Republican Party is left with figuring out what comes after “repeal and replace.”
GOP lawmakers rarely mention Obamacare, and a GOP-backed challenge to the law at the Supreme Court doesn’t appear to be a major threat. Republican attacks on Democrats pursuing a “government takeover” of health care through a single-payer system don’t quite sizzle when President Joe Biden has made clear he wants nothing to do with it. And long-favored Republican designs on shrinking the health care safety net isn’t great policy or politics in the middle of a pandemic and economic crisis.
Which leaves a big fat question mark about what vision of health care Republicans will offer to voters as the country emerges from the pandemic, after a decade in which implacable opposition to the Affordable Care Act was part of the GOP’s core identity.
Xavier Becerra testifies during a Senate Finance Committee hearing on his nomination to be secretary of Health and Human Services on Capitol Hill in Washington, Wednesday, Feb. 24, 2021. | Greg Nash/Pool via AP
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Board Of Governors Professor School Of Public Affairs & Administration
The Trump administration’s efforts to sabotage the ACA and their consequences receive detailed attention in a recently released Brookings book, Trump, the Administrative Presidency, and Federalism. For present purposes, I highlight six major sabotage initiatives which emerged in the wake of congressional failure to repeal and replace the ACA.
1. Reduce outreach and opportunities for enrollment in the ACA’s insurance exchanges. Established to offer health insurance to individuals and small business, the exchanges have provided coverage to some 10 million people annually. The Obama administration had vigorously promoted the ACA in part to attract healthy, younger people to the exchanges to help keep premiums down. The Trump administration sharply reduced support for advertising and exchange navigators while reducing the annual enrollment period to about half the number of days.
2. Cut ACA subsidies to insurance companies offering coverage on the exchanges. ACA proponents saw insurance company participation on the exchanges as central to fostering enrollee choice and to fueling competition that would lower premiums. The law therefore provided various subsidies to insurance companies to reduce their risks of losing money if they participated on the exchanges. The Trump administration joined congressional Republicans in reneging on these financial commitments.
Why Is The Affordable Care Act So Despised By So Many Conservatives
IT HAS been called “the most dangerous piece of legislation ever passed”, “as destructive to personal and individual liberties as the Fugitive Slave Act” and a killer of women, children and old people. According to Republican lawmakers, the sources of each of these quotes, the Affordable Care Act , or Obamacare, is a terrible thing. Since it was passed by a Democratic Congress in 2009, it has been the bête noire of the Republicans. The party has pushed more than 60 unsuccessful Congressional votes to defeat it, while the Supreme Court has been forced to debate it four times in the act’s short history. Obamacare was also at the heart of the two-week government shutdown in 2013. Why does the ACA attract such opprobrium from the right?
Repeal Of Obamacares Taxes Would Be A Huge Tax Cut For The Rich
This did not play a major overt public role in the 2009-’10 debate about the law, but the Affordable Care Act’s financing rests on a remarkably progressive base. That means that, as the Tax Policy Center has shown, repealing it would shower moneyon a remarkably small number of remarkably wealthy Americans.
The two big relevant taxes, according to the TPC’s Howard Gleckman, are “a 0.9 percent payroll surtax on earnings and a 3.8 percent tax on net investment income for individuals with incomes exceeding $200,000 .” That payroll tax hike hits a reasonably broad swath of affluent individuals, but in a relatively minor way. The 3.8 percent tax on net investment income , by contrast, is a pretty hefty tax, but one that falls overwhelmingly on the small number of people who have hundreds of thousands of dollars a year in investment income.
For the bottom 60 percent of the population — that is, households earning less than about $67,000 a year — full repeal of the ACA would end up meaning an increase in taxes due to the loss of ACA tax credits.
But people in the top 1 percent of the income distribution — those with incomes of over about $430,000 — would see their taxes fall by an average of $25,000 a year.
Under the actual AHCA, Jared Kushner would actually pay even less in taxes. As a young person, Kushner would get a larger tax to buy insurance under the AHCA than he does now.
The Surprising Reason So Many People Still Don’t Like Obamacare
The Supreme Court could issue a ruling in King v. Burwell, the lawsuit threatening to undermine a key part of the Affordable Care Act, as early as Thursday. But the debate over President Barack Obama‘s controversial health care law is likely to continue no matter how the justices rule. And one reason is that Americans, on the whole, remain deeply ambivalent about it.
While the popularity of “Obamacare” has fluctuated a bit in the five-plus years since it became law, the amazing thing is how little public opinion has changed. Roughly speaking, a little more than 40 percent of Americans approve of the law, while around 50 percent disapprove — though the precise numbers vary a bit from survey to survey. The public doesn’t support repealing the law, as Republicans would prefer, and at least some people disapprove of the Affordable Care Act because they like the idea of it but wish it went further. But Americans have not wholeheartedly embraced the law, as its proponents have long hoped.
The ACA’s critics, who throw around words like “debacle” and “train wreck,” say these tepid polling results are proof that people directly affected by the law don’t like it. But a review of recent polling, plus some statistical calculations performed at the Huffington Post’s request by researchers at the Henry J. Kaiser Family Foundation, which studies national health policy, suggest two other factors are driving public perceptions.
Here’s a breakdown of the data.
4. Politics is a huge factor.
Gop Needs New Health Care Target; Obamacare Survives Again
WASHINGTON — The Supreme Court’s latest rejection of a Republican effort to dismantle “Obamacare” signals anew that the GOP must look beyond repealing the law if it wants to hone the nation’s health care problems into a winning political issue.
Thursday’s 7-2 ruling was the third time the court has rebuffed major GOP challenges to former President Barack Obama’s prized health care overhaul. Stingingly for Republicans, the decision emerged from a bench dominated 6-3 by conservative-leaning justices, including three appointed by President Donald Trump.
Those high court setbacks have been atop dozens of failed Republican repeal attempts in Congress. Most spectacularly, Sen. John McCain, R-Ariz., flashed a thumbs-down that doomed Trump’s drive to erase the law in 2017.
Along with the public’s gradual but decisive acceptance of the statute, the court rulings and legislative defeats underscore that the law, passed in 2010 despite overwhelming GOP opposition, is probably safe. And it spotlights a remarkable progression of the measure from a political liability that cost Democrats House control just months after enactment to a widely accepted bedrock of the medical system, delivering care to what the government says is more than 30 million people.
“The Affordable Care Act remains the law of the land,” President Joe Biden said, using the statute’s more formal name, after the court ruled that Texas and other GOP-led states had no right to bring their lawsuit to federal court.
Changes Required By The Affordable Care Act After 180 Days
- September 23, 2010 :
- Seniors are entitled to a $250 rebate to close the Medicare Part D coverage gap.
- A government website is created to allow people to search for information about health insurance companies, available plans, and other essential facts.
- Insurers are not permitted to exclude pre-existing conditions from coverage for children.
This Is Why Republicans Couldnt Make A Better Replacement
Republicans have made a lot of political hay out of pointing out that the plans available under the Affordable Care Act are, in many ways, disappointing. Unsubsidized premiums are higher than people would like. Deductibles and copayments are higher than people would like. The networks of available doctors are narrower than people would like.
These problems are all very real, and they all could be fixed.
They are not, however, problems that the American Health Care Act actually fixes. While Republicans have made several changes to the AHCA to cobble together a majority of House votes, the core of the bill remains the same: it offers stingier insurance to a narrower group of people.
This is because the AHCA does what Republicans want: it rolls back the ACA taxes. But under those circumstances, it’s simply not possible for the GOP to offer people the superior insurance coverage that it is promising.
The bill the House is voting on Thursday doesn’t get rid of the ACA’s tax credits to make it easier to buy health coverage, but it bases them on age, with younger people getting bigger credits, rather than income — which means poorer Americans. especially elderly ones, will have a bigger tax burden and more difficulty affording the insurance they need.