The latest CNN poll finds:
Despite a victory lap by the White House following the release of that number, only 12% of Americans surveyed consider the law a success. Nearly half say it’s too soon to tell, and just under four in 10 consider it a failure.
According to the poll, 61% want Congress to leave the Affordable Care Act alone (12%) or make some changes to the law in an attempt to make it work better (49%).
Thirty-eight percent of those questioned say the law should be repealed and replaced with a completely different system (18%) or say the measure should be repealed, with Americans going back to the system in place before the law was implemented (20%).
As it relates to the 2014 midterms, the poll understates the depth of the problem for Democrats. In states such as Colorado, Arkansas, North Carolina and Louisiana, where the Senate majority will be decided, opposition to Obamacare is much higher than in the United States as a whole. This explains why Republicans in these and virtually every (maybe, literally every) Senate race will run on repealing and replacing Obamacare.
Now, our friends on the left like to point to the large number of people who’d like to fix Obamacare. So what are the fixes? How are the Democrats going to fix Obamacare to let people keep their own plans and to simultaneously reduce premiums? How are they going to alleviate the anti-work incentive built into the system? Is the individual mandate, which many people dislike, going to get “fixed”? If Democrats ever were pressed to lay out what they wanted fixed, I suspect that the fixes would be trivial and the problems would remain. This is because the system is not designed to do what its supporters said it would do.
For example, the promise of affordable care was not carried out in any mechanism that controls health-care costs. There is the backup Independent Payment Advisory Board, but that is empowered to reduce payments, not to limit costs. (This is why the result may well be lack of available services, i.e., rationing.) Because Obamacare failed to reform Medicaid, more people are now in a system fraught with waste and fraud. Because the stringent requirements of Obamacare disallowed most low-cost, high-deductible plans, it forced people to overbuy insurance — a formula for increasing, not reducing medical usage and costs.
Take the problem of insufficient signups among young people. The law envisions that the so-called “risk corridors” will take care of the insurance companies. But is that viable, or is eliminating insurance company “subsidies” one of the fixes Democrats will support?
Defenders of the plan say Republicans haven’t put forth an alternative. That is false. James Capretta and Yuval Levin remind us:
Several plans introduced in recent months by opponents of Obamacare — inside and outside of Congress — adhere to these principles in different ways. But the plans with the greatest potential (in terms of both policy and politics) are those sponsored by Republican senators Richard Burr, Tom Coburn, and Orrin Hatch and the separate plan drafted by the 2017 Project, a nonprofit advocacy organization dedicated to promoting a conservative reform agenda.
These plans stand out because they embrace a realistic and practical approach to replacing Obamacare. Most important, they provide access to secure health coverage to all Americans without disrupting the employer-based health insurance system. They do this by embracing a tax credit for insurance for any household that does not have access to an employer-financed health plan. This is a matter of simple fairness. The tax subsidy for employer-paid insurance is very generous, but no such subsidy exists for persons buying insurance on their own. A credit would make available to low- and moderate-wage households who must buy coverage on their own a tax benefit comparable to the one for employer plans.
A lot of people might like that idea even though it is more in the “repeal and replace” than in the “fix it” category.
All of this highlights the opportunity for Republicans. The public is open to hearing about changes, significant changes in the current system, which they don’t like. If Republicans can pass a cheaper, less disruptive version of health-care reform that actually addresses cost, reforms Medicaid and preserves individual choices, that could be very popular. Democrats are hindered because they are tied to an unworkable, gargantuan piece of legislation that fundamentally doesn’t do what most people want. They can tinker with it, but those problems won’t vanish. That is why Republicans — if they offer a concrete alternative — will have the advantage. But that is a big “if.”