Thursday, October 28, 2010

Health reform law alive, if unwell -- Oct. 28, 2010 column


Rarely has a law proved as unpalatable to both the political right and the left as the optimistically titled Patient Protection and Affordable Care Act.

To conservatives, “Obamacare” is a dog’s breakfast of a socialism and big government intrusion. Liberals complain that without a public option, the so-called reform law is just thin gruel. Both sides blame President Barack Obama, and he concedes he has been frustrated with the legislative process.

Unemployment is a bigger issue, but the new health-care law hovered over the midterm campaigns. Seven in 10 people who said they planned to vote said the new law would affect their vote, a survey by the nonpartisan Employee Benefit Research Institute found.

Republican candidates promise to kill the law, but it won’t be easy. Forty-five percent of registered voters want to keep the health-care plan and 41 percent favor repeal, the latest New York Times-CBS News poll reported.

Once again, then, change electrifies the air, but as we’ve learned in the last two years, change is easier to promise than to deliver.

While the new GOP members in Congress may be able to slow the plan’s implementation, repeal seems unlikely, given the close partisan divides in the Senate and House.

Some provisions -- allowing young people to age 26 to stay on their parents’ health insurance plans, outlawing discrimination against sick children and removing the cap on lifetime benefits – are popular. Others, such as requiring everyone to purchase insurance, are in the courts. Health economists still say the plan falls without everyone’s participation.

When Obama went on “The Daily Show” Wednesday to gin up support for Democratic candidates, he again defended the new law, saying 30 million people will now get health insurance coverage. He mentioned a woman in New Hampshire who won’t have to sell her house to get her cancer medications. She doesn’t think the law is inconsequential, he said.

To liberal critics who call his legislative agenda timid, Obama said, “What happens is it gets discounted because the presumption is, well, we didn’t get 100 percent of what we wanted; we got 90 percent of what we wanted – so let’s focus on the 10 percent we didn’t get.”

Obama never persuaded Republicans to back health-care reform, and now he has lost the argument within his own party. Many Democratic candidates distanced themselves from both the Affordable Care Act and the president. West Virginia Gov. Joe Manchin, embroiled in a tight Senate race, once said he’d fix the law when he came to Washington. More recently he has said he wouldn’t have voted for it, period.

My guess is most people who favor repeal have health insurance. They don’t want higher premiums or lower benefits. But the traditional way of getting health insurance – through an employer – is fading.

Fifty-nine percent of non-elderly Americans received health insurance through their employers in 2009, according to the benefit research institute. That is still a majority of those under age 65, but it’s a dwindling majority. In 2000, some 68.4 percent of non-elderly Americans had employment-based health benefits.

With fewer people likely to get health insurance at work in the future, the deep resistance to a public option is puzzling, especially considering the widespread popularity of Medicare. It turns out that other Americans also are more likely to get their health-care coverage through the government.

In 2009, more than one in five non-elderly Americans received coverage through such public plans as Medicaid and the State Children’s Health Insurance Program, which are growing. Only about 6 or 7 percent of Americans purchased their insurance individually, a group that has remained fairly constant.

Obama may wish health-care reform would disappear as an issue, but it’s likely to follow him and Congress into 2012.

On “The Daily Show,” Jon Stewart asked Obama if he might run this time as a pragmatist. Would his slogan be “`Yes we can, given certain conditions?’”

“I think what I would say is yes we can, but…” Obama said, trailing off as the audience and Stewart began to laugh.

“But it’s not going to happen overnight,” the president said. He didn’t laugh.

© 2010 Marsha Mercer. All rights reserved.


  1. Ms. Mercer is on-the-money with her column this week. Her well-written coverage of the the health insurance issue brings out the problems confronting the president and the congress.

    What will happen now that the Republicans have taken control of the House of Representatives and have increased their strength in the Senate? Is repeal a possibility? Not with the president's veto. I am afraid efforts to modifhy that program piece by piece will only make this situation worse.

    In any event, we can be sure Ms. mercer will keep us abreast of what we need to know.

  2. Even though it will be very difficult, the Congress and the President must find common ground for changing the health insurance law so it can be accepted by the bulk of the American people who now object to it in its present form.

  3. Cmcrva3 makes an excellent point. We concur.