Maybe it’s because I spend so much time watching Repub presidential candidates playing the game of I’m More Against Obamacare than Thou (oh yeah, well I was against it first), but I was surprised to see this week’s Pew poll finding that, by a narrow and statistically insignificant 47-45 percent, a plurality of respondents said they approve of the mostly-still-yet-to-implemented health care bill.
This is the fourth time Pew has asked the question, and the first time the approvers outnumbered the disapprovers, but in all four polls, neither approvers nor disapprovers got above 50 percent nor below 40.
U of M political scientist Larry Jacobs has co-written a book about the law (full official name: The Patient Protection and Affordable Care Act), so I asked him about the PPACA’s likely role in the election.
Jacobs surprised me by predicting that it won’t be that big an election issue. The argument over the economy and President Obama’s handling of it will likely dwarf most other issues, Jacobs said, invoking the classic James Carville reminder from 1992: “It’s the economy, stupid.”
Mostly by spreading misinformation about what the law will actually do when fully implemented, Republicans have made it a top issue for stirring up their own base, and the Tea Party has embraced Obamacare as a symbol of big government. But Jacobs predicts that the issue will decline once the general election campaign begins, especially if Mitt Romney is the Republican nominee. (Despite the fact that the national law closely resembles the health care program that Romney signed in Massachusetts, Romney’s stump speech includes a pledge to repeal the federal version of the law.)
Jacobs said he has been impressed by the degree of outrage on the right over the bill and the apocalyptic language about the threat it represents to freedom, especially since the rhetoric is “so out of proportion to what’s actually in the law.” Between the law’s length and complexity and the number of falsehoods that have been circulated about what’s in it, most Americans have a poor grasp of how it will actually change the status quo.
What the law will do
He and his co-author, Theda Skocpol of Harvard, have worked up a summary of the Three Big Things that the law will do when it is fully implemented in 2014:
1. Sets new rules of the game for insurance companies: Insurance companies will not be able to dump policyholders who become ill or refuse coverage to people with pre-existing health problems. They must allow parents to keep their children covered under the family plan until age 26. They will be required to spend at least four of every five premium dollars on medical care.
2. Makes health coverage more affordable: Special credits will make private health plans affordable for middle-class families (earning up to $90,000 a year) and for businesses facing high insurance costs. Medicaid will be expanded so that millions of Americans who work for modest wages will become eligible. When fully implemented, 90 percent of U.S. citizens and legal residents will have access to affordable health insurance.
3. Encourages “health exchanges” for comparison shopping: Every state is induced to set up a so-called “exchange” that enables individuals or families or businesses that provide health care to employees to easily compare the costs and benefits of the insurance policies that are available in their state. Exchanges will also let people know if they are eligible for the new credits to help pay for coverage.