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March 09, 2015 at 08:46 AM
(Bloomberg View) — After Wednesday’s oral argument at the U.S. Supreme Court, the odds that the Patient Protection and Affordable Care Act (PPACA) — Obamacare — will survive its latest legal challenge appear slightly better than even. But instead of relief, the law’s supporters should take a moment to reflect on the deeper problem for the Obamacare: Its persistent and widespread unpopularity. Reversing that will do more to protect the law than any court decision.
A Pew Research Center poll last month reported that almost five years after it was signed, 53 percent of people disapprove of Obamacare — close to an all-time high. That reflects more than just partisanship; even independents dislike the law by almost 2 to 1.
That’s a bigger problem than Obamacare’s supporters seem to realize. Liberals’ hope is that if the law can just survive this legal challenge and succeed on the merits — insuring more people at a reasonable cost — it will eventually gain acceptance, or at least benign indifference. By that view, the low level of public support for the law is either minimally important or beyond fixing.
But if Democrats don’t find a way to address the public distaste, Obamacare will stay vulnerable to the next ploy that comes along to undercut it. The disapproval fuels not just the court challenges but also the obstructionism of Republican executives and lawmakers that makes those challenges so potent. After all, if every state were willing to establish its own exchange, the court’s ruling on King vs. Burwell (Case Number 14-114) would be moot.
To which Obamacare’s supporters might ask, what do you expect us to do? The Barack Obama administration couldn’t do more to trumpet the number of people who are getting coverage through the law’s exchanges. If you want to know how many Colorado residents signed up for a silver plan for 2015, the U.S. Department of Health and Human Services can’t wait to tell you.
By focusing on the expansion in coverage, however, the law’s defenders are fighting the wrong argument. The opposition doesn’t center on the notion that the government shouldn’t be trying to cover more people. It revolves around two other claims, neither of which Democrats have done a good job dealing with. And both of those arguments are mostly bogus.
First is the idea that Obamacare imposes mandates on insurance that needlessly drive up the cost of coverage and restrict choice, a core Republican argument. “Republicans understand that what works in Utah is different from what works in Tennessee or Wyoming,” a trio of Republican senators wrote Sunday in the Washington Post. Under their alternative, “every state would have the ability to create better markets suited to the needs of their citizens.”
What Republicans are arguing against is the law’s requirement that insurance cover 10 types of care: outpatient care, emergency room visits, hospitalization, prescription drugs, laboratory services, preventive care, rehabilitative care, pediatric care, maternity care, and mental health and addiction treatment. Which of those is unnecessary in Utah?
