• My latest thoughts on ACA developments

      05/29/2013
      Aaron Carroll

    I collected my thoughts on the latest developments with respect to Obamacare over at CNN.com.

    Go read!

    @aaronecarroll

     
      Health Policy
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    • by watermelonpunch on May 30th, 2013 at 00:54

      Good commentary. Thank you.

      Interesting, somewhat amusing, rather saddening, while at the same time being shocking and yet typical… The comments thread spiraled into a debate on the Civil War.

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    • by robert aylward on May 30th, 2013 at 08:30

      Asking people if they “support” Obamacare is like asking people if they “support” structural realism. Most health care providers aren’t sure what Obamacare means for them, though some say near universal health insurance will cause a shortage of doctors. To believe Obamacare will cause a shortage of doctors subsumes that Obamacare will cause people to become sick, a ridiculous assertion if ever there was one. My only quibble with Dr. Carroll’s post at CNN is with this statement: “But it’s important to recognize that full-out opposition to reform like this is somewhat novel in American politics.” The constituency that will benefit most from Obamacare is the poor and nearly poor. Even if Obamacare “works”, full-out opposition today will have little or no political cost tomorrow. Sad, but true.

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    • by dbh on May 30th, 2013 at 12:56

      It does not seem that strange that a party that unanimously opposed a piece of legislation, and has voted 37 times to repeal it, would also refuse to consider amendments to improve it. For those who are inalterably oppsed to the ACA, the Republican strategy makes perfect sense. This level of opposition is hardly novel in American politics. Prohibition was unpopular from the start, became more so over time, efforts to amend and improve failed to placate those opposed, and it was repealed.

      It is an interesting political question whether the coming expansion will make the law more or less popular, but opposition to implementation is a logical way to approach a law that one wants to repeal.

      From the political point of view, this strategy is also logical. It shores up the Republican base, draws sharp lines in upcoming elections where there are Democrats running in conservative districts and states, and is consistent with Republican rhetoric. The political experts on the right think this will benefit them. It seems those on the left are more frustrated than elated that the Republicans are being obstructionist. If the left were sure this was a losing strategy, they might be egging the Republicans on.

      It is remarkable that passing the ACA was only a part of the process of implementing it, and that actually making it happen requires billions more in federal expenditures. Since those expenditures will never get through the House, it will be fascinating to see how things play out with an underfunded effort, and most states not establishing exchanges.

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