Compared with earlier presidents, Obama focused his case less on helping the uninsured and more on providing those with coverage greater leverage against their insurers. That shift was especially evident in his final drive toward passage.
And yet, polling just before the bill’s approval showed that most white Americans believed that the legislation would primarily benefit the uninsured and the poor, not people like them. In a mid-March Gallup survey, 57 percent of white respondents said that the bill would make things better for the uninsured, and 52 percent said that it would improve conditions for low-income families. But only one-third of whites said that it would benefit the country overall — and just one-fifth said that it would help their own family.
You can use these numbers to make any kind of argument. You could say that the majority of whites think that health care reform will help low-income people but they just don’t care. Or, you could argue that nearly half of whites refuse to acknowledge that access to health care will actually help people. The most important finding in the recent polling is that whites who have no college education are the most skeptical about health care reform even though they are the main beneficiaries. They tend to work jobs that lack insurance coverage and they pay higher prices in the individual insurance market (or they go without any insurance at all).
Brownstein says that the low-education whites (who were most resistant to Obama’s campaign) think the reforms are transferring wealth to minorities while the stimulus and bank bailout are transferring wealth up to bankers. They are conditioned to think that the government won’t help them. Changing that perception won’t happen overnight, even if they do eventually realize that Obama has done more for them than any president since Lyndon Johnson. For one thing, a lot of low-income whites are now eligible for Medicaid, but think Medicaid is something blacks and immigrants receive. In other words, they might benefit, but they’ll resent the help they get.
These voters are totally unpersuaded by the moral case for health care reform, but they are receptive to sticking it to the insurance corporations. That’s why the public option was consistently the most popular element of the president’s proposals. For all the cries of ‘socialism,’ the charge only stuck when it meant helping black and brown folk. When it meant that you didn’t have to buy private insurance, people actually liked the idea.
A lot of bloggers told the Dems that it was all good to pass reform, but people had to like it. They don’t like this reform because it doesn’t have a public option. You can fix that now, while you have the majorities to do it, or you can take an unnecessary beat-down for it in November. In the longer term, people will understand the truth about these reforms and embrace them and those that protect them. But, not yet. Not now. Stick it to the corporations, on the public option, on the financial reform bill, on anything and everything, and these voters will begin to believe that you are on their side. The Republicans will always appeal to their bigotry, fears, and class-resentment. We don’t want to fight for those sentiments. But, when we do things to help these folks, we ought to make sure they know who helped them and how.
I don’t know how much credence to give to concerns I’ve seen that the reforms that take effect this year have big loopholes –
Dems have to run on these provisions in November, and how the bill works out of the gate will have a big impact on how people perceive it. What are the chances of a quick fix for this stuff?
In a month the Sebelius will come out with new regulations. As for the six month period, that was to be expected.
There is a lag in implementation because: (1) the regulations have to be drafted, sent through and mandatory period of public comment (where the special interests usually create more loopholes because the public isn’t watching and has no one to translate the regulatory language and (2) it takes time to staff up the administrative systems to handle complaints against insurance companies, enrollment forms for any aspects requiring enrollment, changes in IT systems, and so on.
In addition, because the Senate bill depends so much on the existing state regulatory infrastructure, state insurance commissioners have to go through similar implementation processes, but only after they have received the federal administrative funds to do it; states are having budget problems and can’t gin up new programs with their own funds.
It could very well become an administrative mess if the part of the public who are interested healthcare reform do not keep vigilant and keep pushing.
It is doubtful that Congress can do more until next January, which is why folks who support healthcare reform need to be active in November’s election and start putting the pressure on Republican incumbents.
With regard to adults with pre-existing conditions, I wasn’t talking about the implementation period. The law (I love saying that!) actually requires that you have to be without insurance for 6 months before you’re eligible for the new high-risk pool.
They could tighten up these things with a few lines in any bill they pass, so I don’t think it would have to wait until next year.
If they need to. Part of why I brought it up here is that I was hoping someone understands the legal issues better than I do, esp. the issue regarding the children with pre-existing conditions. 🙂
I suppose the (erroneous) thinking about that is that you have to show that you made an effort to find insurance before you can be put in the high-risk pool.
Which is why I say, once again, that Obama missed the boat by hiding from the fight for over a year. Had he fought for a good bill from the start he would have had overwhelming public support – across racial and class lines. The insurance company friendly bill they ended up with was actually HARDER to pass than a better bill would have been because of that lack of public enthusiasm.
Good luck trying to fix it now, after the fact.
if you didn’t notice, senators respond more readily to the insurance industry than to public opinion.
that senators respond more readily to polling and likely-voter feedback than they do to anything else.
you forgot to add, like Blanche Lincoln, for example
if that were true, we’d have a public option.
Especially when the aide who drafted the bill for Max Baucus was the former VP of Public Affairs for Wellpoint.
Given that it took over a year of hard work to pass this legislation, Obama can credibly argue that he did his best with the Congress he had, but that he really wants to add a public option to the reforms already passed. After all Obama was elected to a four year term, and thus has not broken his campaign pledge in favour of a public option just yet.
So the Obama/Dem campaign this fall should be based on a commitment to add a public option to existing reforms in order to finish the job and meet Obama’s campaign promise. He should ask the electorate to give him a Congress he can work with, one that will allow him to pass a public option.
This has the advantages of:
Actually, the PO was not the most popular aspect of the bill. The regulations were.
They don’t like this reform because it doesn’t have a public option.
I think that’s a bunch of bunk.
Moreover, can you explain in easy terms what you mean by “public option”? Throughout this entire debate, the term has meant anything and everything up to and including a shorthand reference to single-payer. It’s goddamn annoying.
At any rate, there never were the votes for what Obama proposed, either in the House or in the Senate. People voted for the House bill because of Stupak’s abortion amendment. The Senate couldn’t even vote on Reid’s initial bill and couldn’t muster 50 votes in reconciliation. That’s just how it is.
The public figured out along about September what the public option was about and then strongly supported it.
The current bill sets up exchanges in which insurers create plans with one of three types of coverage – basic, expanded, even more expanded. The plans must include minimum coverages of services as defined by the law. The basic lacks dental and vision coverage, for example. So the other two add these and other coverage. Insurers can be stockholder-owned, mutual (policyholder-owned, which incudes employers as policyholders), fraternal (owned by members of an organization), cooperative-owned (patient-owned). The insurers submit plans, premium rates, and other information to the administrators of the exchange, who validate conformance to HHS regulations. Then the plans are placed on the exchange, which becomes a (probably online) market for comparison shopping of plans.
A public option means that the federal government would be authorized by Congress to set up plans conforming to the same requirements and be able to list them as competing plans on the exchange. The logic is that these plans, because their premium rates are being set a by the cost of negotiated agreements between the government and providers, would reflect the actual costs of payments to providers and through competition provide a constraint of private rate gouging of premiums through collusion or other non-competitive practices.
One proposal now in Congress, Rep. Alan Grayson’s Medicare buy-in at cost is an example of a way to administer a public plan in the exchange.
Because the exchanges initially apply only to the individual and small business markets, folks with large employer-provided insurance will not be affected until those plans are phased into the exchanges. This allows the exchanges to begin operating administratively with a small number of patients and then expand its scope to the entire market of lower cost plans, the high-end luxury policy market being allowed to operate outside the exchange. The assumption is that those folks who can afford luxury policies have the financial sophistication to shop for them carefully and the resources to pay providers directly if they don’t find adequate coverage.
The public option was popular with people who had insurance and did not intend to change to a public plan precisely because they saw the competitive value of having public plans available. Which made it very friendly to the middle class.
The public option establishes the framework for single payer if it turns out that the exchange-and-regulation system does not work. You essentially open the public plans to anyone who wants to buy them. And it provides a key means of determining when the exchanges are not working–when more people are buying public plans than private plans.
Because of this potential to drift into a single-payer system, providers don’t like it. And the American Hospital Association apparently bargained to have it not be in the bill, which is why at every point where it might have passed it mysteriously got jerked away. In return the American Hospital Association hospitals allowed some significant reforms in the bill that represents a multi-billion concession of prices over ten years. And they held back on massive public relations and advertising efforts to kill the healthcare reform bill altogether.
For one thing, a lot of low-income whites are now eligible for Medicaid, but think Medicaid is something blacks and immigrants receive. In other words, they might benefit, but they’ll resent the help they get.
…
A lot of bloggers told the Dems that it was all good to pass reform, but people had to like it. They don’t like this reform because it doesn’t have a public option. You can fix that now, while you have the majorities to do it, or you can take an unnecessary beat-down for it in November.”
Funny, watching you argue against yourself.
Medicaid isn’t so great. Trying to find a Medicaid (S-CHIP) supporter for my grandson. Looking 30 miles out. Everyone says, “No No”, now that the state legislature has decided (again) to cut payment levels. Good news is that it looks like in a month I’ll be able to add him to my Blue Cross and then with the new law, he will be covered until age 26 with insurance that doctors will actually take.
In Illinois, you are pretty much limited with Medicaid to going to the nearest hospital (they have to take it by law) and the nearest pharmacy (they have to take it by law). Doctors are grumbling about the Medicare cuts. Soon the situation will be the same. Dropping Medicare is happening slower because more patients are involved.
Booman- I think you’re missing the point here. The “low-education white vote” is likely the part of the electorate that is most racist, homophobic, and anti-Muslim. Passing a public option, while a good thing, wouldn’t change most of their minds about Obama. The only thing that is going to change their minds is jobs. That’s it. When they all have jobs, they won’t care that a black man is helping them out. Until then, they are going to hate Obama and hate most Democrats.
There is a segment who are small business owners who have also fallen on hard times. When their business picks up, they also won’t care who helped them on the way back to prosperity.
But they also are not likely to remember at the ballot box.
I don’t think even jobs will change their minds about the black man in the white house.
I agree that some people are just diehard racists/homophobes/Muslim-haters. We’ll never get those votes. The Tea Party is never going to vote Democratic. But, there are a lot of voters who have mildly racist/homophobic/anti-Muslim attitudes who would vote Democratic if unemployment rates were low and they had good jobs. We don’t need every vote – we just need enough to maintain big majorities.
No but the working class whites that didn’t show up in Massachusetts voted for Obama before and aren’t the tea party!
If that were the case why did these massachusetts working class whites vote for Obama last in 2008. How come they didn’t have a problem in 2008?
I admit I don’t want this bill simply because it enriches insurance companies much more than the workingclass, thus giving them more money to use to corrupt the system against people like me!
low educated Whites have always clinged to their Whiteness…with the election of Barack Obama…what do they have left?
God and guns…
Then why did those massachusetts voters vote for Obama in 2008, if they are endemically. You neolibs conveniently forget massachusetts all the time!