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Does the Patient Protection and Affordable Care Act need title reform?

So how, exactly, did the law end up with a handle like "puh-pack-uh"? Creators of the law did pay some attention to its name, Mellman said, but in the end, it was designed by committee. To satisfy more people, the name became long and inclusive, giving it less of a chance to catch on and be used, he added. And that opened the door to "puh-pack-uh," health-care reform and the Affordable Care Act.

"This was a missed opportunity," said Lake, noting that the name problem is symptomatic of a broader problem among Democrats on health-care overhaul.

"There wasn't nearly enough branding of health-care reform," she said. "Because of that, we paid the price throughout the whole debate."

Now, the branding "has to be done through the prism of repeal and replace," she said. "It's a Republican message, and we have to do our message through the prism of that."

Republicans, for their part, are satisfied with their "Obamacare" branding. GOP pollster Bill McInturff, partner at Public Opinion Strategies, asked voters in September whether the term "Obamacare" was a net negative, and 10 percent said that it was somewhat negative; 37 percent said that it was very negative.

Rep. Michael C. Burgess (R-Tex.), who is pushing for repeal of the law, said that calling it the Affordable Care Act is a misnomer.

"I even had an amendment to strike the word affordable from the bill's title, but I didn't get anywhere with it," he said.

As for "puh-pack-uh"? That, he said, "kind of reminds me of those people who invested heavily in those llama-like animals."

Kaiser Health News ( is an editorially independent news service of the Kaiser Family Foundation, a nonpartisan health-care policy organization that is not affiliated with Kaiser Permanente.

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