How to improve Obamacare and fix the Democrats’ midterm problem in your spare time
Poll numbers are the only numbers anyone is talking about this weekend before the midterm election. But last Friday, the Department of Health and Human Services announced a number that would have been huge news only months ago, when Republicans and the media were desperate for any news that Obamacare wasn’t working.
HHS offered three key findings from a new report from Gallup- Healthways Well-Being Index:
- As of June 2014, 10.3 million nonelderly adults (ages 18-64) gained health insurance coverage since the start of the Affordable Care Act initial open enrollment period in October 2013.
- The uninsured rate among nonelderly adults fell by more than a quarter (26 percent), from 20.3 percent to 15.1 percent, comparing numbers as of June 2014 with the January 2012-September 2013 baseline period. African Americans and Latinos saw particularly large drops in their uninsured rates of 6.8 percentage points and 7.7 percentage points, respectively.
- Government and private surveys offer a consistent picture of expansions in insurance coverage.
So in six months, America cut its uninsured population by more than a fourth. And these six months also happen to coincide with what could be the best year of job growth in the United States this century.
Democrats haven’t run on this remarkable achievement for some pretty obvious reasons. The next Senate majority is being largely decided in states where the Obama part of Obamacare is particularly unpopular, and the people most helped by the law are least likely to vote, especially in midterms.
The most obvious reason why it’s difficult to run on Obamacare is that no one is signed up for Obamacare. This is why Mitch McConnell can campaign against the law in the state that has been most benefited from it, while only vaguely having to admit that he’s promising to strip coverage from 500,000 Kentuckians.
The reality is that as many as 28 million Americans are covered by an Affordable Care Act-compliant plan, according to ACASignups.com. All of us benefit from the new regulations that demand insurers spend 80-85 percent on care. All of us benefit from the end of discrimination against people with pre-existing conditions. All of us benefit from the deficit savings from the law, which is part of an overall health cost slowdown that could shave trillions off our debt, far more than painful reforms like raising the Medicare retirement age or raising beneficiaries deductibles proposed by Republicans.
Still, that doesn’t make it easy to campaign for a law that requires you to take ownership of the American health care system, which costs more and covers fewer people than any system in the industrialized world and was terribly unpopular even before the ACA.
Some Americans — mostly those who earn more than 400 percent of poverty — have been asked to pay more. Some had coverage they liked saw it canceled by insurers who felt the plan would no longer be profitable — though that happened all the time before the ACA with no guarantee you’d be able to find coverage that would accept a pre-existing conditions. The trend of premiums and deductibles rising has continued — though at a much slower pace. And changing the health system at all activates fear that the Medicare that seniors have worked their lives for will be take away.
Yet in six months, 10.3 million people have gained a new security as the U.S. government has made it’s largest attempt to fight inequality in decades — possibly generations. And we’ve made the first serious attempt to tackle the $1 trillion our broken health care system costs our economy each year.
So what will Republicans do next?
Mitch McConnell’s spokesbro made this promise to conservatives after briefly noting the reality that repeal of the law is unpossible under President Obama:
Leader McConnell is and has always been committed to the full repeal of Obamacare, and he’ll continue to lead efforts to repeal and replace it with patient-centered reforms that enable greater choice at lower costs. He knows it won’t be easy, but he also believes that if Republicans are fortunate enough to take back the majority we’ll owe it to the American people to try through votes on full repeal, the bill’s most onerous provisions, and reconciliation.
McConnell will use every tool at his disposal to force President Obama to chip away at the law. We’ve seen a debt limit crisis and a shutdown that put leeches on our economy. And we will be wise to expect something even worse in the next two years.
That’s what you get when you have a country that votes for change every four years and then sits home for the midterms.
Obamacare can and must be improved. Xpostfactiod has some great suggestions for how to get started. But let’s stop defending the law and go on the offensive.
There’s a huge improvement to the law that Democrats should begin championing today: Let all Americans buy into Medicare.
Enacting a public option is as probable with a Republican Congress as repeal is with a Democratic president. And it’s far more popular.
If and when Democrats define themselves as the party that only strengthens and expands Medicare and Social Security, the senior vote that’s keeping the GOP alive will slip away.
[Image by Gage Skidmore via Flickr]
