Columns » Ernest Dumas

7 million reasons not to repeal the ACA



On the last signup day for first-year insurance coverage, Ross Douthat, the quasi-official Republican intellectual, wrote an obituary for the forces that hoped to repeal Obamacare when Republicans control all three branches of government.

Writing in the corner of the New York Times reserved for conservative orthodoxy, Douthat said repeal won't happen now because it depended on Obamacare tripping over its complexities and failing miserably to achieve its goal of expanding insurance to a significant part of the population.

Four and a half months ago, he wrote that the cataclysmic failure of the Internet portals established for the signups and then the cancellation of substandard insurance plans in December in spite of the president's promise that insurance companies wouldn't do that meant that it was possible, maybe likely, that the reforms would be so discredited that Obamacare could be repealed when the party got its majorities.

But with the first-year prediction of 7 million new insurance buyers a certainty in spite of all the administrative glitches and with many million more poor workers signed up for Medicaid (200,000 Arkansans by the end of this year), that possibility vanished, Douthat said. Repeal or any serious change that canceled coverage for millions of people, he wrote, will not appeal to even many Republicans and will produce only "a ruinous civil war" in the party.

Douthat always viewed the reforms as another welfare-state entitlement like Social Security, Medicare and veterans insurance, which if the law worked would become widely accepted and even popular. While polls show Obamacare still unpopular, Douthat saw signs of its growing popularity like Medicare and Social Security before it.

Forlorn as he is about the prospect of killing the law, Douthat does not call on his party to abandon its plan to use Obamacare to win both houses of Congress this year, the last chance to exploit it. The most successful public-relations ruse in history was to make the Affordable Care Act "Obamacare" in the common parlance, thus linking the reforms to a president who was hated in the South and the deep-red mountain and Midwestern states.

Polls show people favor the Affordable Care Act and that all its major features except one, the individual mandate, are wildly popular, and the mandate is a trifle below 50 percent. But approval sinks when people are asked about "Obamacare."

Even as it surpasses the first signup threshold, Obamacare political ads proliferate. As of March 1, 66,000 ads had attacked Democrats and more than 30,000 blamed the Democrats for Obamacare. The number of Obamacare ads is 12 times the number at this stage of congressional races four years ago, when they enabled Republicans to take over the House of Representatives.

On almost any website you go to, an ad flashes a picture of Pryor and the words he "told the biggest lie of the year." Then a very sad Wanda Buckley of Marion tells about how grieved she was when Blue Cross canceled her insurance in spite of Obama's promise that she could keep it. There was nothing about Pryor lying, but the ad notes that he voted for the act. And the Arkansas insurance commissioner said Blue Cross could continue to cover Mrs. Buckley and others like her with the substandard plans for another two years.

Pryor had seen his high approval ratings four years ago plummet because of the Obamacare attacks, but a year ago he counted on implementation at least neutralizing it as a political issue if not turning it into a positive.

The bare numbers ought to bear out his hopes: 200,000 voting-age Arkansans with insurance for the first time, thousands more who had lost insurance because they had pre-existing conditions or their illnesses had become too long and expensive insured again, 500,000 Medicare enrollees who are having their out-of-pocket drug costs lowered and have access to free cancer screenings, 35,000 young adults back on their parents' insurance, 115,000 Arkansans who got rebates last year because insurance companies spent more of their premiums on profits and overhead than Obamacare allows, 1.3 million whose insurance as of Jan. 1 can never be canceled as long as they pay their premiums.

But Pryor voted for Obamacare.

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