{"id":346317,"date":"2025-12-13T12:06:15","date_gmt":"2025-12-13T12:06:15","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/346317\/"},"modified":"2025-12-13T12:06:15","modified_gmt":"2025-12-13T12:06:15","slug":"obamacare-changed-the-politics-of-health-care","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/346317\/","title":{"rendered":"Obamacare Changed the Politics of Health Care"},"content":{"rendered":"

Here are some data points that Republicans ought to bear in mind as they contemplate their health-care strategy.<\/p>\n

Donald Trump is unpopular for many reasons, not least of which is the public perception that he has failed to bring down costs, as promised. Next month, more than 20 million Americans may see their health-insurance premiums spike, some by double or more, when expanded Affordable Care Act subsidies expire. Also, American support for the 2010 health-care law, otherwise known as Obamacare, has reached a new high of 57 percent, according to a recent Gallup<\/a> poll.<\/p>\n

Despite these facts, Republicans just voted to let ACA subsidies expire. How is the public likely to respond to this between now and the 2026 midterm elections? Probably not by warming up to Republicans.<\/p>\n

Fifteen years after its passage, the ACA is a gigantic political pain point for the GOP. You would think Republicans would have made their peace with the law by now and turned their attention to other issues. But unlike pretty much every other conservative party in the industrialized world, where the legitimacy of universal health coverage is largely a given, the GOP seems resigned to bleed out on health care.<\/p>\n

A largely unspoken article of faith for Republicans is that access to medical care is a matter of personal responsibility. They don\u2019t generally advertise this belief, because it is not popular\u2014a growing share of Americans believe that it is the government\u2019s duty to ensure all citizens have health-care coverage, according to Gallup<\/a>. So the party\u2019s strategy instead was to fight proposals to expand coverage. Until the ACA, this proved effective.<\/p>\n

Read: \u2018We are looking at a massive crisis\u2019<\/a><\/p>\n

The United States has two features that have made enacting universal health insurance especially difficult. One is its legislative system, which, unlike parliamentary forms of government, requires multiple concurrent majorities, including a Senate that gives conservatives disproportionate representation.<\/p>\n

The second is the nature of America\u2019s employer-based insurance, which sprang up during World War II and gave working-age Americans a stake in a privatized status quo. The fear that health-care reform might compromise this insurance complicated the politics, and ensured that Congress cared more about preserving insurance for those who had it (particularly as they tended to be educated and engaged voters) than extending benefits to those who didn\u2019t.<\/p>\n

The ACA broke through decades of gridlock by keeping the employer-based system intact and building up coverage options for people who couldn\u2019t access it. Low-income workers, whose jobs mostly didn\u2019t provide health care, would get Medicaid. People with higher incomes who didn\u2019t have access to employer coverage would get subsidized coverage on individual exchanges, which would have to sell plans to customers regardless of health status.<\/p>\n

Passing the law proved challenging. Republicans made all sorts of terrifying claims about its effects: The exchanges would collapse; health-care costs would skyrocket; insurers would employ \u201cdeath panels\u201d to decide which patients were worthy of care. None of those things happened. The death panels were imaginary, the health-care-cost curve bent downward<\/a>, and the exchanges drew millions of willing customers and worked just fine.<\/p>\n

Republicans never reckoned with the failure of their doomsaying prognostications to come true. Nor have they fully assimilated how the politics of health insurance have changed since the law\u2019s passage. It was easy enough for Republicans to block health-care reform when a program to expand coverage didn\u2019t exist. Taking insurance away from people who have it, or jacking up the price they pay to get it, is a completely different matter.<\/p>\n

Some Republicans recognize that their impulses are unpopular, but they are not interested in accommodating public opinion. House Speaker Mike Johnson, who appears to represent the majority of Republicans on the issue, has called the ACA marketplace \u201ca broken system,\u201d as if the predictions of its collapse had come true, and treats its beneficiaries\u2014who are now at a record high of 24 million people, or 7 percent of the U.S. population\u2014as if their numbers are slight enough to be ignored.<\/p>\n

\u201cYou\u2019re going to see a package come together that will be on the floor next week,\u201d he told reporters Wednesday, \u201cthat will actually reduce premiums for 100 percent of Americans who are on health insurance, not just the 7 percent.\u201d Before the Affordable Care Act, the needs of uninsured people could be brushed aside. Johnson\u2019s dismissive reference to \u201cthe 7 percent\u201d seems nostalgic for that political world.<\/p>\n

Trump has generally attempted to bluff his way through the problem. In his first term, he repeatedly promised to \u201crepeal and replace\u201d the ACA with a terrific system that would give everybody much better insurance for less money. This worked as a campaign promise but has proved impossible as policy.<\/p>\n

In his second term, Trump\u2019s approach to wishing away the trade-off between paying less and getting better care has been to claim that he can bypass the insurance market completely by giving people money directly, thereby allowing them to get more for less. \u201cI want to give the people better health insurance for less money,\u201d Trump told<\/a> Politico\u2019s Dasha Burns on Monday. \u201cThe people will get the money and they\u2019re going to buy the health insurance that they want.\u201d<\/p>\n

Annie Lowrey: How are we still fighting about Obamacare?<\/a><\/p>\n

Trump\u2019s plan seems to invoke the hazy concept that people can buy their own medical services like items at a grocery store. That does not work with medical care, because people rely on doctors for advice on what services they need, and because medical costs frequently spike far beyond what anybody can reasonably afford, which is why almost everybody pays for it through insurance.<\/p>\n

The president inadvertently confirmed this when he attempted to describe his concept to reporters on Tuesday. \u201cI love the idea of money going directly to the people, not to the insurance companies, going directly to the people. It can be in the health savings account; it can be a number of different ways,\u201d he said. \u201cAnd the people go out and buy their own insurance, which can be really much better health insurance, health care.\u201d<\/p>\n

So Trump\u2019s \u201cplan\u201d is to stop giving money to people to buy insurance, because that enriches insurance companies, and instead give it to people to go buy \u2026 insurance. This sort of nonsense talk may work well enough when Trump wants to just get through interviews without admitting a problem. But it isn\u2019t a workable solution to soaring insurance-premium fees come January.<\/p>\n

Perhaps the GOP will one day recognize that its aversion to widening access to health-care coverage is just too politically costly, too untenable, to so stubbornly maintain. Until then, Republicans act like they are operating in a world where the ACA hasn\u2019t already given millions of Americans this essential benefit, and where these same Americans won\u2019t be bothered when this benefit is taken away.<\/p>\n","protected":false},"excerpt":{"rendered":"Here are some data points that Republicans ought to bear in mind as they contemplate their health-care strategy.…\n","protected":false},"author":2,"featured_media":346318,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253],"class_list":{"0":"post-346317","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-health","9":"tag-health-care","10":"tag-healthcare"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/346317","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=346317"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/346317\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/346318"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=346317"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=346317"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=346317"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}