November 27, 2014
Much of the public remains badly confused about the Affordable Care Act (ACA). This shouldn’t be a surprise. It is a complicated bill. Also, there has been much effort to deliberately create confusion. For example, Republicans invented stories of ACA death panels and massive job loss. Major media outlets, in their commitment to neutral reporting, treated such claims seriously, along with the assertion that the earth is flat.
While the public’s confusion is understandable, if regrettable, the confusion among elite types is far more disturbing. Earlier in the week, New York Senator Charles Schumer, the third ranking Democrat in the Senate, admonished his party for pursuing Obamacare rather than promoting stronger measures for the economy. Schumer didn’t explain why he thinks not pursuing health care reform would have increased support for bigger budget deficits or a lower valued dollar to reduce the trade deficit, the necessary steps for fixing the economy.
But the really striking part of Schumer’s comments was his confusion about the status of the uninsured. He asserted that they were a small part of the electorate and most don’t even vote. Washington Post columnist Charles Lane chimes in today, largely agreeing with Schumer on this point.
Contrary to what Senator Schumer and Mr. Lane seem to believe, being uninsured is not a permanent state. People move in and out of jobs and marriages, and their insurance moves with them. (More than 4.5 million people lose or leave their jobs every month.) The number of people who are uninsured at some point in a year is more than 50 percent larger than the number who are uninsured at a point in time.
This means that if 50 million people are uninsured on any given day, it is likely that more than 75 million people will be uninsured at some point over a year. This would likely increase to 100 million over the course of two years. If we add in the close friends and immediate family of these uninsured individuals, it would almost certainly be a substantial majority of the voting age population.
It is reasonable to believe that these people who face and fear periods without insurance would value the security provided by the ACA, since it means that they can still get insurance during these periods. However this security will not affect the popularity of the bill if people are not aware of it. Since Senator Schumer and Charles Lane apparently do not understand this essential aspect of the ACA, it is likely that the tens of millions of people who have day jobs (unlike Schumer and Lane) also don’t understand the security provided to them under the law.
The ignorance of this and other aspects of the law likely helps explain much of the law’s unpopularity. Opinion polls consistently show overwhelming public support for most of the key features of the bill when asked separately.
It is also worth calling attention to a bizarre assertion in Lane’s piece. Schumer notes that the economy has been very weak leading to stagnant incomes for most of the population. He then comments:
“In theory, at least, this should be a time of electoral triumph for the party of government.”
This is bizarre because both parties are the party of government, the question is what the government is used for. The Democrats have not distinguished themselves in a big way from Republicans in this area. The top leaders of the party all supported the bailout measures that largely kept Wall Street intact by shoveling the big banks trillions of dollars of below market interest rate loans and guarantees at a time when liquidity carried an enormous premium. The Obama administration has also gone to bat for them by blocking a European tax on the financial transactions of their European subsidiaries.
The Democrats have also used the power of government to make the patent monopolies of the drug companies stronger and longer and spreading them around the globe in trade agreements. In the latter case the profits for the drug companies come at the expense of other exports. The same story applies with stronger and longer copyright protection for the entertainment industry.
They have also constructed trade agreements that are explicitly designed to put U.S. manufacturing workers in direct competition with low paid workers in the developing world. At the same time the Democrats use the power of government to protect the most highly paid professionals (e.g. doctors, lawyers, and dentists) from the same competition.
In short, most of the public sees the Democrats as one of the parties of government that uses the power of the government against most of the public, because it happens to be true.
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