As someone in the comments at the Washington Post notes “How can you make something “great again” that wasn’t great in the first place?” Catherine Rampell gives it a shot
Believe it or not, Americans like Obamacare. They just don’t know they like Obamacare.
Consider the prohibition on denying insurance coverage due to preexisting conditions. Seven in 10 Americans, including 6 in 10 Republicans, support this provision, according to a recent Kaiser Family Foundation poll.
What about allowing young adults to stay on parents’ plans until age 26; eliminating out-of-pocket costs for preventive care; providing subsidies to low- and moderate-income Americans to help them purchase coverage; and helping states expand Medicaid to cover more uninsured low-income adults?
At least 80 percent of Americans are fans of every one of these provisions. Among Republicans only, at least two-thirds are, too.
Let’s not forget, those were thrown in to make Ocare popular, to go with all the things, like the taxes/fees/fines, higher premiums and deductibles, lower levels of care, government involvement, etc, that aren’t.
The only major component that a majority of Americans don’t like is the individual mandate — that is, the requirement that nearly all Americans sign up for insurance or pay a fine.
But as is often pointed out, you need this unpopular provision to preserve the popular one about preexisting conditions. Without a mandate, only increasingly sick people will buy coverage, sending insurance markets into a death spiral.
Except, that’s who is buying a goodly chunk of the Ocare plans via the government run markets.
All of which is to say that Obamacare does not have a policy problem. It has a branding problem.
Quite a bit of the problem is the rule making. The slapping on taxes for things like medical devices and device development and tanning salons, the contraception mandate (which, once again, is not even mentioned anywhere in the bill, nor is sterilization nor abortifacients), setting the work hours and which companies get nailed, the exemptions for lawmakers and some unions, etc.
Americans don’t even recognize Obamacare’s one inarguable accomplishment: the precipitous decline in the uninsured rate.
Which could have been done without the giant tentacles of government insinuating into our lives to this degree. Of course, the point of Ocare was not to succeed, but to fail requiring the creation of a public option, leading to Single Payer.
Trump may have little interest in policy, experts, numbers, details. But he is undoubtedly a marketing genius. One possible outcome of the current repeal-and-replace free-for-all is that congressional Republicans decide to keep essentially the existing system in place, with some reforms, improvements and hole-plugging, and Trump slaps a shiny new name on the whole thing.
Welcome to the revolutionary, gold-plated “Trumpcare.” Has a nice ring to it, don’t you think?
Nice wish. Won’t happen. What will most likely happen is that all the things mentioned at the beginning are retained, while all the bad parts, all the parts that increase the power of the federal government, are toasted. There are entirely too many things to just fix. Toast the law, you toast all the rule making. For instance, people would be able to save as much as they want for their Health Savings Accounts, which are limited per Ocare. There are just too many problems.
What they really want is the preservation of the Exchanges (which are utterly failing at this time), so, as they collapse, they can continue to push for the public option then Single Payer. They’re thinking long term. What if Trump utterly fails, and loses in 2020? He could easily take the Congress with him, putting Democrats back in position to attempt their government solutions to a greater degree. They’re playing the long game.