This column by Drew Altman, president of the Henry J. Kaiser Family Foundation, highlights what appears to be a big disconnect between voters and lawmakers when it comes to repealing and replacing Obamacare. Trump voters and Republican lawmakers are united, it seems, in their dislike of the Affordable Care Act. Where they are divided is on what comes next. Research done by the Henry J. Kaiser Foundation indicates that the voters have pretty definite ideas on what they want to see as a replacement. Repeal does not seem as important to them except as necessary to fix the problems they are having.
Lawmakers, on the other hand, seem pretty eager to repeal Obamacare but are vague – and have been vague for seven years of opposing the ACA – on what comes next. Trump voters (and probably most voters) are going to be unhappy if lawmakers proceed on the path they appear to be on.
The study indicated that the primary concerns of these Trump voters were:
- A fear that they would be unable to afford coverage for themselves and their families.
- Anxiety about rising premiums, deductibles, copays and drug costs, and particularly surprise bills for services that turned out not to be covered.
- Resentment that poorer people, eligible for Medicaid, seemed to be getting a better deal than they were.
- Animosity toward drug and insurance companies.
- Frustration at being forced to change plans annually to keep premiums down, and losing their doctors in the process. (Surveys show that enrollees in the ACA marketplace generally are happy with their plans, but the average Trump voter seems to not have fared as well under Obamacare as the average citizen.)
- Dissatisfaction over losing an ability to purchase lower cost policies, even if that loss was cost-shifting that resulted in more and better coverage for others.
According to the column and the study:
If these Trump voters could write a health plan, it would, many said, focus on keeping their out-of-pocket costs low, control drug prices and improve access to cheaper drugs. It would also address consumer issues many had complained about loudly, including eliminating surprise medical bills for out-of-network care, assuring the adequacy of provider networks and making their insurance much more understandable.
The survey subjects were surprised and dismayed to hear about the current plans that had been floated. They recognized that “a tax credit to help defray the cost of premiums, a tax-preferred savings account and a large deductible typical of catastrophic coverage” was “not insurance at all.” They were skeptical of the concept of health savings accounts.
But, they were confident in Mr. Trump’s ability to protect people with pre-existing conditions without imposing the un-American mandates. Because, in their mind, Mr. Trump is a smart businessman, he would not allow the chaos of a gap between the repeal and replacement of Obamacare.
Well, the election is over. They won this one. But, as the George Washington character says in Hamilton, “winning is easy, young man. Governing’s harder.”
It seems mind boggling that the public bought a pig in a poke. I must assume they agreed that we needed to elect Trump before he said anything concrete with just one exception, the Great Wall! Now that is something we can all be positive about?
If I were as good a businessman as Mr. Trump, I’d be living in a shack or a jail.
I just wonder how long it will take Trump supporters to understand that they didn’t get what they voted for in Mr. Trump, that he isn’t such a hot businessman and they have been conned. What will happen when they bring out the pitchforks?
They will keep on supporting and defending him because they have been conditioned to obey – unquestioning – the leader of their chosen group.
Actually, that’s true with most people, no matter their political leanings.
I agree, especially with the authoritarian group, but there has to be some point or behavior somewhere where it’s so outrageous that they almost have to pull the plug. Like a recorded phone call with a quid pro quo with Putin or something. I think that very few of our members of Congress have the moral courage to do such a thing on their own unless they are overwhelmed with constituents who tell them to impeach the guy or they will bring out the pitchforks.
Doug Masson says
I am almost always surprised about that moment when a politician or party loses support. Stuff that I think should cost them support never seems to and stuff that I think seems pretty trivial somehow tips the scale. Iraq War? No problem. Terri Schiavo? Big problems.
“Iraq War? No problem.”
Still find that one just stunning.
Our lowest point this century until Trump.
They won’t see it because it will always be someone else’s fault.
Obamacare will be blamed for the reason why Medicaid/Medicare/Social Security has to be gutted. “I wanted to keep your coverage, but Obamacare was so bad I couldn’t.” It doesn’t line up with the facts, but those will just be explained away as “fake news” and the “liberal media”.
My favorite part of the article was this:
And they say millennials are self-centered. I’m gobstruck that people don’t realize that all insurance, even pre-ACA insurance, was/is risk-sharing.
They don’t believe in risk-sharing, for illogical reasons. As far as I can tell it’s a mixture of unexamined and unresolved feelings — jealousy, fear of someone benefitting in some way I may not benefit (coupled with a lack of gratitude), lack of compassion, magical thinking that bad things will never happen to me, and the fatalism that if they do that’s just the way things are.
Rick Westerman says
Heck, except for point #3 I have had the same concerns about my Purdue-provided health care. Prices keep going up while (for a while) wages were stagnant; having to change plans and providers yearly as Purdue scrambles to keep costs down; arguing with insurance providers about what is covered; resentment at the medical companies — why does physical therapy charge $150+/hour to have someone watch me do exercises? why can’t anyone tell me what a procedure will cost before I get it done?