Before the Affordable Care Act became the law of the land, people had two main attitudes about their health insurance. They either hated it, or they didn’t use it. This idea that there were a lot of people who liked their health insurance and wanted to keep it is largely a myth. At best, the vast majority of people were afraid of change, but that doesn’t mean that they thought they had great insurance or enjoyed the process of trying to get their insurer to pay their bills. In general, people hate paying for insurance and experience hassles when they try to use it. So, once the Democrats decided to push everyone into for-profit insurance, they pretty much took ownership of something most people experience negatively. Add to this that people will always want a bigger subsidy than they’re getting, a bad rollout of the exchanges, and a political opposition uniformly opposed to the bill and determined to highlight every flaw within it, and you have a recipe for a political drubbing. That’s why I think Teacher Ken is wildly optimistic when he declares that the benefits of the law will become clear by next November’s midterm elections. I do not believe that to be the case.
The only way to make that the case is for Democrats to very thoroughly follow Ryan Cooper’s advice and rally around the health care law in a relentless and single-minded way that can match the Republicans’ opposition.
I have further advice on this front. The fact that formerly uninsured people are getting insurance is not a very compelling rejoinder for someone who is having a negative experience with their health insurer. What’s compelling is a political party that constantly points to the benefits of the law, like annual caps, keeping your kids on your insurance, protections against having your insurance dropped, and limits on profit-taking. The way to promote this politically is to constantly talk about real people who would have been screwed without the reforms. Trot them out daily to talk about how their lives and livelihoods have been saved.
Secondly, the Dems should be introducing reforms that address areas where people are experiencing problems. These reforms won’t pass, but they can form a platform of sorts that will partially inoculate the party from criticism. After all, fixing a problem is better than repealing the whole law and having a solution is more appealing than having none.
If the Democrats do not pursue these two strategies and just rely on people discovering that the law is working, they will be slaughtered. They will be slaughtered because people hate health insurance.