The Affordable Care Act was signed into law three years ago this week, and while a great deal has changed for American consumers and the nation's health care system, the politics of health care remains largely stuck.
Yesterday, for example, congressional Republicans voted for the 36th time to repeal "Obamacare," as part of a vote on the budget process, and today, they'll cast their 37th repeal vote. Apparently, old habits die hard.
But what about with the public at large? The Kaiser Family Foundation published its latest non-partisan report this week, and there were some striking details in the survey results.
There's quite a bit to chew on in the results, but this chart, published by the KFF in its report, struck me as the most interesting. Many provisions in the Affordable Care Act are extremely popular, enjoying at least two-to-one levels of public support, but (a) most Americans still have no idea what's in the law; and (b) the most popular provisions are the ones Americans don't know about, while the least popular provisions are the ones Americans do know about.
No wonder "Obamacare" isn't more popular. The mainstream doesn't yet have enough information to realize how much they support it.
Indeed, it appears the key takeaway from the latest survey is that confusion still reigns. Not only does much of the public not realize that popular ideas are included in the law, many Americans think imaginary provisions are included in the ACA -- 57% believe the law includes a public option (it doesn't); 47% believes it extends benefits to undocumented immigrants (it doesn't); 44% believe it cuts benefits for Medicare beneficiaries (it doesn't); and 40% believe death panels are real (they're not).
Some wealthy and powerful opponents of the White House invested heavily to make sure as many Americans are as confused about the Affordable Care Act as possible. Three years after the reform plan became law, they've clearly had a fair amount of success.
As long as we're on the topic, let's also note that Republican opponents of "Obamacare" used to talk quite a bit about a "repeal and replace" strategy. The idea was, Republicans realized that the American mainstream wants to see real improvements to the old, dysfunctional system that cost too much and covered too few, so they'd kill the ACA and replace it with a superior alternative.
In time, however, GOP officials effectively gave up on the "replace" part of the plan, and simply tried (and tried, and tried) to repeal the Democratic law. In theory, it's not too late -- Paul Ryan's House Republican budget repeals the parts of the Affordable Care Act that actually provide benefits to Americans, while keeping the parts of the law that generate revenue, and could theoretically point to Republican-friendly health care reforms. Some notable conservatives find it "rather odd" that GOP lawmakers refuse to outline a replacement for "Obamacare."
Jon Chait explained the other day that it's really not odd at all: "It's the furthest thing from odd. It's the House Republican ideology."
Putting into place some different plan to cover the uninsured would cost money. Republicans don't want to spend money covering the uninsured.
Now, it's true that they're happy to wave around vague plans to cover the uninsured as an effort to "show" that they have a plan of their own, as part of the effort to oppose health-care reform. I'm sure many Republicans actually agree with those plans, at least in the abstract. What they don't agree with is the idea that it's worth having higher taxes in order to subsidize access to health care for people too poor or sick to buy it themselves.
Let's just make this plain: Republicans don't see tens of millions of uninsured Americans as a problem. They don't see American families being pushed into bankruptcy -- the only advanced country on the planet that allows this -- as an issue in need of a remedy. They've admitted this many, many times.
Their plan for the future of health care is to repeal the Affordable Care Act, end Medicare, and allow free-market forces to magically meet consumers' needs.
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Conservatives have argued to me that the ACA should be repealed because it leaves 30 million uninsured. However, the same people have no plan to cover any uninsured. It's not cognitive dissonance. It's cognitive cataclysm.
The GOP used to scream Repeal and Replace! Which morphed into Repeal and...well, just repeal! And to hell with all those people that have preexisting conditions - including children, or cancer, or...or...or....
The GOP is the party of psychopaths. They surpassed sociopathy long ago. Conservatives are truly mentally ill (as evidenced numerous times during the Republican primary debates). Not only that, but they have an incredible inability to comprehend their own lack of compassion, empathy and humanity. I try to feel sorry for them but I have a hard time feeling anything for people who whoop and cheer the death of others.
The opponents have been successful because Mencken was right back in 1924: "Nobody ever went broke underestimating the intelligence of the American people."
Repeal Republicanlackofcare.
I like that label - GOP Lackocare
The biggest failure of the proponants of the AFCA is that they did a very bad job of selling it. They have let to opponants control the message.
Yes, and also most people are too lazy to do their own research on the law and rely solely on what biased sources on both sides of the issue (but mostly on the GOP side, as evidenced by the above graph) deem fit to tell them about it.
I took an online quiz about the facts of the law once (I don't remember where, or I would link). When the results came up at the end, it said I was among only 4% of the population able to answer all of the questions correctly. That's just sad.
That has been a chronic problem for the Obama administration...they have let other groups and interests control definitions and the terms the discussion.
I honestly think that part of it comes from the ridiculous continuing search for a "Grand Bargain"...which they are about as likely to find as a yeti or the Loch Ness monster.
Yes, and also most people are too lazy to do their own research on the law
Including the Congress that passed the law. They were given a few hours to research and understand the law that consists of thousands of pages.
Rickwang: The bill was debated for months. Why do you lie...
Obama and the Dems failed to sell the ACA and let Republicans dictate the message. That is why people believe all of the lies about the act and know nothing of what is really in it. You can't go back in time, but the Dems can still sell the bill in 2014. The contrast to Ryan's budget is then very striking to voters because the plan has no parts that deal with the "replace" slogan. It would put Republicans on the defensive to have to explain the replace part. And vouchers are not going to do it.
@Lebowsky, the lies go back to Pelosi who said that people would have to wait for the bill to be passed so that they - the constituents - could see for themselves what was actually in the bill- so they would realize that the Fox News/Sarah Palin Death Panel, et al, bull@!$%# was complete nonsense. Which then morphed in the conservative lie-o-sphere to CONGRESS had to wait until it was passed to read it. Conservatives, all bull@!$%# all the time.
I honestly think that part of it comes from the ridiculous continuing search for a "Grand Bargain"...which they are about as likely to find as a yeti or the Loch Ness monster.
Yeah, both sides are crazy: The Republican pass the repeal of Obamacare for the 37th time and Obama goes for the Grand Bargain for the 40th. "Doing the same failed thing in the expectation of a different outcome."
My father constantly regurgitates the "we have to pass it to know what's in it" line. I never knew how to respond to it. Go figure it's something taken out of context & spun by Fox ("You didn't build that", "Why does it matter how they died"...). My husband is a small business owner & hates Obama. He also has a demyalinating nervous system disease. He came home all in a huff about "Obamacare" being too expensive for them as a small business (which they are exempt from) and he was just going to have to stop providing insurance & he was going to have to "go on Obamacare". For such a smart man...smh. He would flunk any test on the provisions.
It's simple... Once this kicks in, people are going to like it, alot. The Republicans know that, so they keep up the manure-based attacks. Kinda the same thing with Immigration Reform, they don't want it because of the votes...
I look at it like this, your political affiliation is not a sports team. If your Giants or Knicks are having crappy seasons, you stick with your team no matter what. If you are a Republican and your "team" is constantly screwing you over, you would vote for the ones who are going to do the most to help you get by, unless your home team can convince you to stay with lies. If the Republicans wanted to make Obama look bad, they would simply let his policies pass and let them fail, but since they have a better than average chance of doing well, they have to misinform people to keep them voting agains their own self interest, and the press is helping to sow the confusion...
Ain’t it the truth?
It is sickening when people vote against their best interest time and
time again.
The chart represents a giant fail for the administration and the media. It takes a while before a new adminstration learns that the news media is really in the entertainment business and entertainment is not the same as education. Fights sell, telling the facts doesn't.
I think you are correct, fights do sell. But governing is not something that needs a propaganda budget or stipend. It's simple governing to identify a problem and create a legislative pathway to fix the problem. The Republicans made a decision to fight the ACA full tilt with fabrications, and they have been largely successfull in the public polling. I would prefer being treated like the intellectual I think I am, just the facts please, so I say let them lie about the ACA all day. When the rubber hits the road they will be in the dust.
Wouldn't it be nice if MSM reported more on the good things in it instead of the teapub talking points?
The mainstream doesn't yet have enough information to realize how much they support it.
Perhaps because of how thoroughly the public has been informed by the
MainstreamCorporately Owned Media?This isn't the first time polls have shown the Democratic party are under-selling themselves due to lack of effective communication of their results. If the general public was aware of all the benefits of the ACA, it would make it far harder for the repubs to successfully repeal it.
Blame that on the Liberal Mainstream Med ...
Oh, wait.
I still hear about death panels from time to time from low information sorts.
Speaking of low-information people; I received a notification on Facebook from my wife. Someone had forwarded to her that one requirement of the ACA was to have an electronic identification chip inserted beneath the skin on the back of one hand. Along with that was an urgent plea to inform as many others as possible. My wife asked me, sincerely, if that was true...I told her with that post and two pieces of bread I could make a baloney sandwich. The original post came from someone in India.
Not too long ago, I saw a Facebook post referencing an AP article that triumphantly proclaimed the proverbial smoking gun: Rationing of care was coming, and it was right there for all to see in an unbiased article.
I read the article, and what it said was that people who are obese or who smoke consume more medical care resources than average but are averse to programs that would help them become more healthy. Since they don't want to change, is it more humane to allow them to continue their unhealthy ways but live for a shorter time or force them to change? That's all. Really. I tried to tell the person who wrote the post that a more careful reading would show this, but she didn't want to hear it.
Now, she does live in the red state of Oklahoma, but this is an educated woman who is a psychotherapist. She should be able to read better than that. We went back and forth a couple of times, relatively cordially, and when she couldn't prevail, she changed the subject.
Now is a good time for the Democratic Party to run attack ads on TV and expose the GOP lies regarding Obamacare. Two benefits are obvious.
1. Americans get educated about Obamacare's true provisions.
2. Americans discover the GOP is a misinformation machine and can't be trusted.
The Repubs are trying to protect the "provider class" that will pay for ACA. The Dems are trying to protect the "recipient class" that will benefit from the law. What t comes down to is who pays and who gets.
@Rick - total nonsense. You obviously are completely unaware that the ACA is a private-market-based model that was born at the conservative Heritage Foundation, which Republicans loved until Pres. Obama said it also worked for him.
You are benefiting from the ACA right now by being protected from insurance company abuses. Does that make you part of the 'recipient class'? Everyone benefits from the law. You seem to know nothing of it but the pablum you're being fed on talk radio. For those who like to think for themselves, here's a link to key elements of the law:
http://www.healthcare.gov/law/features/index.html
The Healthcare Supply Chain Association (HSCA) has compiled a list of 48 medical device and supply companies that have already told hospitals that they will pass on the costs of a 2.3% excise tax mandated by the Affordable Care Act (ACA).
So what?
June
I've never been abused by an insurance company. In 2008 I racked up $450,000 in medical bills and my insurance company paid for everything they were supposed to. The only time I heard from them was when they informed me that they paid another claim. No complaints....no regrets.
SO What??
Just one of any new ACA taxes on the way.
The middle class will be targeted to pay for this.
And hospitals will, in turn, have fewer uninsured patient dollars to write off, which will lessen the overall impact of that excise tax.
Rick - that's fine about your half-million in bills being paid by your insurance company without a peep, but it certainly is the exception. And with that in mind, I have to wonder how easy it would have been for you to get insurance again should your company ever have decided to drop you, which they could have done at any time before the law was passed. Before the ACA, it would have been almost impossible. Now, insurance companies will not be able to exclude those with pre-existing conditions. That's what I also mean by insurance company abuses.
Yes, so what to the 2.3% tax if you're also not going to discuss how the advance tax credit that many will receive to help pay for premiums and how the annual rebate that insurance companies must now pay out as the difference between what they take in and what they use towards consumer services will affect whether that cost is actually covered and negated altogether for consumers.
If you haven't familiarized yourself with the bill and looked to gain an understanding of it first-hand as many of us have, it makes little sense to try to post intelligently on it here.
paid by your insurance company without a peep, but it certainly is the exception.
Sorry but that's the rule not the exception. I have friends that do business with United Health also.
should your company ever have decided to drop you
I don't have a "company' or a job.
I was referring to your insurance company.
And please tell me you understand that the serious problems encountered by consumers around the subject of healthcare encompasses many more millions of people than just you and your friends?
the subject of healthcare encompasses many more millions of people than just you and your friends?
Why is it that millions of people can't afford insurance? Less than 1% of the population are born with issues that prevent them from caring for themselves. What are the others doing wrong?
Rick: thanks for your newfound presence here, taking up the slack in our daily education in how ignorant ignorance has to be, to be one of you fools.
It frightens me that people actually believe pre-existing conditions only include medical conditions one is born with, and completely ignore the fact that millions of people acquire conditions or have accidents during the course of their lives that also bar them from getting insurance (and when we are able to get it, it is incredibly expensive). I'm a self-employed diabetic who buys my health insurance on the private market, I know whereof I speak.
What TCinLA and Freddie said.
So you're halfway to your lifetime limit already! Think you can keep under the cap for the rest of your life, or do you need to take out a supplemental policy to cover the remainder?
You didn't have to have a medical condition to be refused coverage either. I know people that were refused under a pre-existing condition for take antibiotics for an infection, ten years prior. And I also know people that were refused with NO reason. Just a form letter saying they denied them. Insurance companies are not there to care for people, they exist to make money.
Perhaps the Democratic Party has done a poor job of selling The ACA because they, themselves, weren't sure what was actually in it. Nor did they understand the benefits until they were manifested. That being said, it's no longer acceptable to NOT know what's in it and start the education process. Knowledge is power and the Dems are far behind the Right Wing media in getting information out (and it's time to get the correct information out).
The ACA is the law. Starting next year an American will likely have the freedom to change jobs when they would like to. Thats all the "selling" we need IMHO. Getting into the weeds with people willing to lie will not end well. Governing the country is what we need to do, the Republicans are out of that business...
You are so right @Lebowsky Dude. It's hard to imagine that the days of "I would leave this job if I didn't need the insurance" will be over. Woot!
Lebowsky Dude have you written a letter to the editor of your local newspaper sharing that factoid? June is right. I have heard "I would leave this job if I didn't need the insurance" far too often.
i always find it amusing that the gop says; trust the businesses, they will take care of you. really! you mean like shipping millions of jobs to china or india. you mean like forcing wages down so the workers have less buying power. you mean like cutting your hours so they don't have to pay any benefits. you mean like lobbying congress to allow more and more loopholes so they can hide more profit. we the customers pay for every cent that a business pays out. every cent! i talked to some friends the other day. they said that the workers would have to pay more money for health insurance. but it is interesting to note that the salaried people got their insurance completely free. so we treat the people who are actually making the money a hell of a lot worse than the people setting on their butts shuffling paper. no wonder this country is struggling!
this is so true.
Alan Grayson was right...nothing the GOP has done has made him wrong on what he said was the GOP plan.
Has the KFF asked MSM journalists the "aware element is in ACA" survey questions? I'd bet they'd do no better than Americans at large.
I remember all kinds of cartoons and advertisements for public awareness when I was a child -- from the old "I'm only a bill" cartoon to all those 'public service announcements' on fire prevention, etc. Why not have a campaign on this, since the PR job the GOP did against it was apparently so successful?
The most amusing thing about all of it is that when Repubs are pressed on their prescription, so to speak, for health care reform, it sounds a lot like Obamacare. Tom Price (R-Confederate State of Georgia) was on C-SPAN this morning and the host had the wherewithal to ask him how he would "fix" the American healthcare system. Guess what he called for? Insurance portability, no exclusions for pre-existing conditions, tax credits and deductions to help people buy insurance, try to get everyone covered, shore up Medicare. It was hard to understand where exactly his problem with the ACA lies, except he did repeat the lies about government bureaucrats getting between you and your doctor and "death panels". They're really just phoning it in at this point.
Drinking is good and lots of fun, mandatory drinking not a good idea even its really optional, cheers hears to you!
Americans still cling to the dead idea that medical care is there but not anyone's personal responsibility. You get the ignorant "that's what emergency rooms are for" when it comes everyone contributing or paying a penalty. Being responsible may be the biggest hurdle this society has ever faced.
Why is it that other countries can provide high quality
universal health care at a fraction of the GDP that we pay and still have
millions with no health care? Don’t give
me any bull about ours being so superior it naturally cost more. I would say ninety-five percent of you have
never visited a country or spoken with a person of another nationality about
their universal coverage. Don’t tell the
lie that those people come to this country because they can’t get treatment in their
own country or the wait is too long. How
many times do you hear people with good health insurance complaining about
their health care provider? I hear it regularly. If we would’ve had universal coverage forty
years ago, our cost would be less than half what it is today. Do some research.
I prefer to be in the 28% tax bracket and pay 10k a year for insurance than be in the 60% (European) bracket and get health care free. Universal health care is only a bargain for the 47%.