Democrats have been consistently bashed on President Obama’s signature legislative achievement since 2010. That year, angst about the law and the stuttering economy fueled massive GOP gains.  Now Democrats have a new strategy heading into the 2014 midterms; embrace the most popular provisions of the law while downplaying other aspects.  But this might be a hard strategy to make work in conservative and swing districts.

The latest RCP average of polls finds the law deeply unpopular as a whole.  The most recent survey from NBC News/WSJ finds that only 37% support the law and 49% oppose the law.  Even though the poll found that voters did support some aspects of the law the negative outweighed the positive.  This has made Republicans salivate at the prospect of a fight over the law again (just like 2010).

At the end of this year every state will have to decide the cost of the minimum five plans that will be on the state exchanges.  These plans range from a catastrophic coverage plan available only to 18-29 year olds to the most expensive Platinum Plans.  But whether the exchanges will all be ready by the end of this year is a big if.  Delays have been anticipated by many HHS officials who have testified before Congress.  Secondly, many of the regulations needed to govern the exchanges are still being written by the HHS and state legislatures. This likely has caused millions of Americans and many businesses to stay in limbo and be unable to decide what to do about their Healthcare plans.

At both an electoral and legislative level these problems make it hard for Democrats to embrace the law.  Not surprisingly, Democrats have publicly voiced their worries about the law. Senator Max Baucus (D-MT) worried the law could be a “train wreck.”  Democrats running for reelection in conservative states that voted for the law in 2009 and 2010 seem to be hoping voters can separate the bad parts of the law from the good.  However, their Republican challengers are unlikely to let them get away with doing so.

Legislatively, deep public opposition to the law makes it harder to retain the core of the law and reform some of its more onerous measures.  Outspoken freshman Senator Elizabeth Warren (D-MA) has spoken out against the law’s tax on pharmaceutical companies.  These companies provide Massachusetts thousands of well-paying jobs.  Similarly, Senator Dick Durbin has worked to alleviate some of the law’s taxes on major financial institutions.  Both the efforts of Warren and Durbin have not met with much success.

Obamacare’s unpopularity presents Republicans with a unique opportunity that goes beyond winning elections.  Republicans have continually educated the public for three years on the flaws and failures of the law.  They have seized on reports such as those out of Oregon stating expanding Medicaid does not lead to better health outcomes.  They also have circulated an independent report that states the California exchange plans would raise premiums for a healthy individual by 64%-146%.  But what Republicans have failed to do is educate the public on their alternatives.

In 2011 the GOP proposed a small Healthcare reform plan.  It called for allowing insurance shopping across state lines, allowing states to create regional co-ops (similar to state exchanges but run by state rules and policies) and providing vouchers or tax credits for those who qualify; mostly low-income individuals.  The plan was talked about by Republicans early in 2011 but soon left the dialogue when debates over the debt ceiling and student loans heated up.  Republicans would be smart to bring these ideas back into the national dialogue.

Allowing for the shopping of insurance across state lines has the potential to break up many of the monopolies large carriers have.  This could allow new competition into the market and drag down prices; a good for the consumer.  The creation of state led c0-ops is being done in Arkansas (beside the federal exchange) and would allow states and local policymakers to make key Healthcare decisions for their states.  Lastly, vouchers or tax credits for low-income individuals without insurance would not burden the strained Medicaid program and would also allow these individuals to shop for the plan best for them.

It is not surprisingly a plan that comes out of the depths of DC would think centralizing Healthcare plans into a government approved market (the exchange) would save people money and time.  But many individuals know otherwise.  That is why it is crucial Republicans seize on this opportunity and use it.  If they do not, than perhaps conservatives should start looking for a new party to express their ideas through.


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