A recent Kaiser Health Tracking Poll shows that more than half of the public — 53 percent — has a negative view of the Affordable Care Act, aka Obamacare. That’s up eight percentage points since the same poll in June. Yet in just about every poll, just about every answer about the individual aspects of the ACA puts those aspects in positive territory.
So what gives? Why such a disconnect? There are many reasons, but much of it boils down to a poor job of coverage by the media.
To be sure, the Obama administration and Democrats did not do a good job of selling the ACA when it finally passed in 2010. Timing was everything, and they missed the timing. Democrats scared of the 2010 mid-term elections were unsure of how to sell it, so they didn’t try. (Note to Dems: You’ll do a lot better if you don’t run away from your accomplishments). So people who didn’t know much about the new law instead heard the falsehoods being spread by the other party, which were covered ad infinitum. DEATH PANELS! No, not even close. GOVERNMENT-RUN HEALTH CARE! Actually, these are plans offered by insurance companies.
From the new Kaiser poll: “The poll finds misperceptions about the ACA persist: fewer than four in ten are aware that enrollees in new insurance under the ACA had a choice between private health plans, while a quarter incorrectly believe they were enrolled in a single government plan and another four in ten are unsure.”
(As usual, the posters at DK were ahead of the pack on reporting this new survey. Still, I thought I would give it my two cents' worth.)
By all accounts, people who received coverage under the ACA are doing better by leaps and bounds. After the truly disastrous rollout in October, the website got fixed, people were finally able to connect online, and “navigators” helped people find coverage. According to one Kaiser survey, 10.6 million Americans received help with ACA covereage. And those people sought help because they didn’t understand the ACA — 87 percent in this survey said they had limited understanding of the law.
The Henry J. Kaiser Family Foundation, really the gold standard when it comes to polling and information about health care coverage and especially about the uninsured, systematically reports how health insurance coverage has changed since the implementation of the ACA. Six in 10 people who now have coverage through the ACA previously were uninsured, according to another Kaiser survey. The number of Americans without insurance is dropping. In states that expanded Medicaid, even more people have coverage. The people who are left the worst off are poor people living in states without Medicaid expansion.
And what about health care costs? Again, the news from the implementation of the ACA is positive. There are many factors that affect health care costs, but growth in Medicare and Medicaid costs has slowed. The projections from a report by Social Security and Medicare trustees about the future of Medicare have improved — the fund is expected to be solvent until 2030. The ACA is projected to cut $716 billion in expected increases to providers and insurers between 2013 and 2022.
Of course, back in 2010, the overwhelming forces against the ACA took up all of the air time. There were busloads of Tea Partiers — with buses paid for by organizations backed by monied special interests — attending town hall meetings. Those same Tea Partiers were screaming falsehoods about the new law. “Take your hands off my Medicare!” was a famous sign. As if the most successful government-run health program in history is not run by the government.
What’s a lazy reporter to do? Actually explain what’s in the new law? Of course, that would require actual work in reading it. Instead, it’s easier just to turn the cameras to the latest guy in a colonial tri-corner hat and to quote the latest soundbite from a Republican member of Congress, even when that soundbite has no basis in reality. “It’s not my job to explain the law,” was a famous quote by Chuck Todd, chief White House correspondent for NBC News. Really, Chuck? Since when isn’t the media’s job to report on laws that Congress passes? That’s what journalists always have done.
There have been some notable, positive exceptions. The always-excellent Julie Rovner, health correspondent for National Public Radio, did a superb job of explaining the law in weekly reports. She had regular reports in which she answered listeners’ questions. She understood the law so well, as a matter of fact, that she left NPR to work for Kaiser Health News as the Robin Toner Distinguished Fellow. She’s still doing excellent work there, but it’s the listeners’ loss that she’s not around to explain parts of the law anymore.
The partisan drumbeat is still strong. In the Kaiser poll, among the 53 percent who say they saw any political ads about the law in the past month, more than twice as many say the ads they saw were mostly in opposition to the law rather than mostly in support of it.
Remember that in 2006, when the law establishing Medicare Part D — that’s the part of Medicare that helps cover seniors’ drug costs — went into effect, the partisan bickering was over, even though passage of the bill was as sleazy as it got. The GOP-led House suspended its rules to let the vote to pass it continue for two hours instead of 15 minutes while John Boehner (R, Sun Lamp), then the GOP majority leader, reportedly ran around the House floor literally passing out campaign donations from tobacco companies. Thomas Scully, administrator of the Centers for Medicare & Medicaid Services, threatened to fire Medicare Chief Actuary Richard Foster if he reported how much the bill would actually cost. At the same time, he was negotiating for a new job as a pharmaceutical lobbyist. Former Rep Billy Tauzin (R, Drug Money), who steered the bill through Congress, left soon afterward to take a $2-million-a-year job with the Pharmaceutical Research and Manufactures of America.
But the bill passed. Sen. Hillary Clinton was quoted as saying that although she didn’t like the way the law was passed, it was law, and she would help her constituents understand the workings of the law so seniors could sign up for drug coverage. Other Democrats did the same. Contrast that with many GOP members of Congress, who refused to give constituents any information when they called asking for information about the ACA.
And what was the media coverage of Medicare Part D? Think back. I remember many stories about confused seniors being confronted with too many coverage choices. But I also remember lots of stories about what the different choices were, and how seniors could get help from drug companies and pharmacies — indeed, insurance representatives often were in local Walgreen’s to explain coverage to older folks.
Possibly the most important takeaway from the new Kaiser poll is that a majority of Americans want Congress to improve — not repeal and replace — the law. It’s been four years, and the Republicans still have not offered a replacement plan for the Affordable Care Act (they say they’re “working on it.”) And no wonder — whenever they offer anything specific, people hate their ideas.
So please, Congress — this law isn’t going anywhere. Let’s all work on improving it, removing the objectionable parts and fixing the unworkable aspects. In other words, let’s do what Congress has always done in the past.
What do you think the chances are of that?
This is cross-posted at my own website, politicalmurder.com. And from the Dept. of Shameless Self-Promotion, if you're interested in a murder mystery mixed with political media satire set at a Netroots Nation-type convention, check out The Political Blogging Murder, available as an e-book in a variety of formats for a mere $2.99.