Maybe Republicans aren't so opposed to health care reform after all. After grandstanding against the Affordable Care Act for the past few years, Republicans aren't ready to let the entire bill die should the Supreme Court overturn the law later this summer. Congressional Republicans are crafting a contingency plan to reinstate some of the popular elements of the bill in that scenario, according to Politico. It's a clear indication that the GOP has learned the same lesson as Democrats: while the all-encompassing idea of Obamacare may fair poorly in the polls, voters typically support individual elements of the bill.
The wise Harold Pollack has argued that health care reform is in some ways the best covered social policy story in the history of American journalism. That isn't to say there hasn't been plenty of crappy coverage, but there has never been the same volume of informed and insightful reporting and analysis available in so many places on a pressing policy debate.
And yet it's easy to get depressed about the impact all that good work didn't have...
As the House prepares to vote on the "Repeal the Puppy-Strangling Job-Vivisecting O-Commie-Care Act," or whatever they're now calling it, the White House and its allies actually seem to have their act together when it comes to fighting this war for public opinion. The latest is an analysis from the Department of Health and Human Services on just how many people have pre-existing conditions, and thus will be protected from denials of health insurance when the Affordable Care Act goes fully into effect in 2014:
As you probably know by now, Republicans say they want to repeal the Affordable Care Act, but when you start asking them about the ACA's provisions -- like a ban on exclusions for pre-existing conditions, or subsidies to small businesses -- they'll invariably say, "Well, we don't want to repeal that. Just the awful socialist parts. We'll put that back in once we 'repeal and replace.'" The thing they do want to repeal is the one unpopular provision, which is the individual mandate to carry insurance. Unfortunately, the whole thing doesn't work without the individual mandate, which brings everyone into the system. (This is particularly true of the ban on pre-existing conditions.
As you no doubt remember, much of the Affordable Care Act doesn't go into effect until 2014. In order to deal with the problem of people whose pre-existing conditions make insurance companies uninterested in giving them coverage, the act provides for the creation of high-risk pools for people who have been uninsured for over six months. States can establish the high-risk pools themselves (some states already have them), or they can let the federal government do it for them.
Last week, I commented on some Republican senators who pretended that you could outlaw denials of health coverage for pre-existing conditions without having an individual mandate by suggesting that they just don't care enough about the policy dilemma to bother making sense. Not so Roy Blunt, a Missouri congressman running for Senate. This is a guy unconcerned with saying what's politically popular (via Think Progress):
You don't have to expect every politician to be a serious policy wonk to believe that he or she ought to have a grasp of at least the basics of the key issues they debate. And if they don't have that grasp at the beginning of a debate, then they ought to by the end of it. If there's one thing we can say about the last year, it's that we all learned a lot about health-care policy. Or at least most of us did.
During the health-care summit, both Obama and Biden tried to make the point that both Republicans and Democrats agree that there should be some government regulation of health care; they're just disagreeing about exactly how much. As they observed, GOP members of Congress have signed on to certain kinds of regulation (the popular kinds), like ending recissions (where your insurance company kicks you off your policy when you get sick) and even outlawing denials for pre-existing conditions, which is a large change with serious implications.
Howard Dean's "kill the bill" assault on the Senate health reform bill isn't justified, at least by his own standards a few months ago. The main attack Dean has volleyed against the current bill is that it lacks either a public option or a Medicare buy-in. That part is consistent with what he's said all year. But Tuesday night on MSNBC and yesterday morning on CNBC, Dean said the bill is not even "insurance [regulation] reform":
Matt Yglesias observes the appealing incoherence of the Right, in contrast to the coherent but politically unpleasant and morally questionable policies that the administration has been forced to carry on to prevent economic collapse.
Regarding my earlier post, it's important to point out that insurance company discrimination against domestic violence victims applies regardless of whether the woman is still married to or living with the abuser. In other words, women who have successfully left an abusive relationship and turned their lives around continue to be punished for a crime that was committed against them.
The White House and allies are trying to build support for health reform by emphasizing exactly how horrific insurance company discrimination against "pre-existing conditions" can be. One example: In Washington, D.C. and eight states, domestic violence is considered a pre-existing condition. And as Ryan Grim reports at the Huffington Post, one of the Republicans in the influential Gang of Six, Mike Enzi, has a history of support for insurance companies' discrimination against domestic violence victims: