Obamacare-Protest

(A version of this Health Alert was published in the San Francisco Chronicle on August 10, 2015.)

Polls consistently show that Obamacare is unpopular. Back in April 2010, the month before the law was signed, 46 percent of all adults surveyed had a favorable view of the Affordable Care Act, while just 40 percent had an unfavorable view, according to the Kaiser Family Foundations’ regular tracking poll. Things have not changed much since then.

Yet, the law now appears to be hurting Republicans politicians more than Democrats. It looks like Congressional Republicans, who have controlled both chambers of Congress since January, are running out of excuses for failing to advance a comprehensive proposal to repeal and replace Obamacare.

The law has been re-written many times since 2010. Nothing major has been done in Congress, but President Obama, through various agencies’ administrative actions, has skirted the letter of the law. The two big re-writes, however, were done by the U.S. Supreme Court in June 2012 and June 2015. The first re-defined the penalty for not complying with the mandate for an individual to buy health insurance as a tax, thereby rendering it constitutional. The latter repealed the statute’s ban on paying tax credits to health insurers in states without their own state-based health insurance exchanges.

Free of further significant legal challenges, Obamacare is here to stay until a future Congress and president repeal and replace it. One might think that such an overwhelming task would lead ordinary Americans to throw in the towel on resistance to Obamacare. It has not happened. The Kaiser Family Foundation’s July 2015 poll shows only 43 percent of adults view Obamacare favorably, and 40 percent view it unfavorably. Remarkably, that is pretty good for Obamacare: Every poll between February 2013 and March 2015 showed Obamacare more unfavorable than favorable.

Obamacare, of course, is a creation entirely of the Democratic Party. Democrats have dodged every opportunity to “fix’ the law, although they claim they are open to doing so. And yet, Obamacare now hurts Republican politicians more than Democratic ones, according to a July poll from the Pew Research Center. Asked which party is better able to handle health care, 46 percent chose Democrats and only 36 percent Republicans.

Even President Obama himself is polling better on health care, despite respondents’ disapproval of the law that bears his name.  He is still slightly upside down, with 50 percent disapproving, versus 46 percent approving. However, his numbers are moving in the right direction. Last December, 56 percent disapproved and only 39 percent approved of his handling of health care.

The big move has been among young adults, aged 18 through 29, whose approval of the president on health care has jumped from 37 percent to 52 percent. This is remarkable because Obamacare has caused health insurance premiums to skyrocket for young people. The president bet that the young would not notice this because billions of dollars of tax credits disguise the full cost of Obamacare. He is winning that bet.

Of course, it is an old saw horse that people trust Democrats over Republicans on health care. But this gap was closing until very recently. Back in July 2004, 50 percent thought Democrats were better able to reform the health care system, versus only 23 percent for Republicans. During the Obamacare rollout, Republicans began to win on health care. In September 2013, they actually edged out Democrats on this question, 40 percent to 39 percent.

It is not hard to figure out why Republican politicians are slipping again on health care. Since taking control of Congress, its politicians have focused on small fixes supported by health industry lobbyists, designed to get bipartisan support. Examples are the so-called Medicare “doc fix” and the repeal of the medical device excise tax. These, and many other things need fixing. However, they are no substitute for replacing Obamacare.

NCPA’s proposal is a universal, refundable tax credit to help every American pay for health care that he or she chooses, free of federal red tape. Can that really be such a hard sell? The time for Congressional Republicans to show progress on comprehensive health reform is running out.

Source: Health Policy Blog