Monday, July 17, 2017

Promises to "repeal-and-replace" Obamacare

As Republicans' "repeal-and-replace" efforts stall out, yet again, it is worth taking some time to point out some of the small-d democratic issues involved here.

Political science buzz-word alert:  responsiveness.  It means having policy changes respond to public opinion.  When the ACA passed, here's the question.  Was that responsive or not?  At the surface level, no.  "Obamacare" was not popular.  Some of that was branding.  Once you put the name, "Obamacare" on it, it became unpopular.  Then again, there were three primary aspects to the policy: regulation of insurance companies to prevent discrimination on the basis of "pre-existing conditions," subsidies, and the mandate.  The first two were popular.  The third was unpopular.  Taken together, were they collectively unpopular because of the balance between the three, or because of the name, "Obamacare?"  The only way to tell would be to walk people through the healthcare economics of the bill, and ask them, after a long explanation, what they thought.  The problem is that most Americans have the attention span of a puppy with attention deficit disorder, and can't focus on anything longer than... SQUIRREL!  (I haven't even seen that, but I know the reference.  Hey, I did a modern reference!).  Without the ability to walk some poor schlub through the mechanics of healthcare reform, we can never know what people think of the tradeoffs, so we are left with the fact that, when Obamacare passed, it was unpopular.

And, now it is slightly net popular, with Republicans in a bind.  They promised for seven years to repeal Obamacare, and now, Obamacare is net popular, and their bills, in each form, are far more unpopular than Obamacare ever was.

That's actually kind of an interesting bind.  You have a critical campaign promise, made repeatedly over seven years that, if broken, makes you pretty small-d undemocratic.  On the other hand, all of your bills are very unpopular and the thing that you are trying to repeal is now net-popular.  Responsiveness, anyone?

There isn't actually a solution here.  Let Obamacare stand, and you are breaking a central campaign promise.  Repeal it, and you are doing something extremely unpopular.  This is, of course, something that Republicans understood about the necessity, from their perspective, of stopping it before it went into effect.  Once people start benefiting from a program, you can't take those benefits away, or at least it is exceedingly difficult to do so.  Prior to Obamacare going into effect, it was unpopular, and Republicans, had they been in a political position to do so, could have repealed it, and they would have been living up to a campaign promise by repealing an unpopular law.  Small-d democracy in action.  Now, they're trapped.

1 comment:

  1. The campaign promise, though, was to stop the evil Obummer from kicking puppies.

    At some point, the problem with small-d democracy is small minds.