Wednesday, January 22, 2014

The ACA's Obamacare Problem - Jonathan Bernstein // American Prospect

Jonathan Bernstein is right.  The ACA is a reform of the insurance markets and an expansion of Medicaid.  People who have insurance will think they bought private insurance and willbe little aware of the subsidies that made it affordable.  People on Medicaid will think they have Medicaid, or MediCal, or whatever.  They'll still be against Obamacare, or for it but they won't see this as a government program when they go to Covered California or Healthcare.gov. They'll think they're buying insurance - and that it costs too much and covers too little.  - gwc
The ACA's Obamacare Problem:
by Jonathan Bernstein
From the very beginning, and certainly before Democrats also adopted “Obamacare” as the shorthand name for health-care reform, Republicans have strongly opposed a fantasy version of the landmark legislation. Whether it was “death panels,” or “government takeover,” or any number of wacky claims in chain emails, Republican opposition has rarely been focused on what’s actually in the ACA.And no matter how successful reform turns out to be, that’s unlikely to change.See, the funny thing about the Affordable Care Act is that a whole lot of it will either be invisible or, oddly enough, won’t be identifiable as “Obamacare.” The core of the program is the system of health-insurance exchanges and subsidies, but little or none of these operations will have the words “Affordable Care Act,” much less “Obamacare,” attached to them. Nor are the exchanges what people think of going in as Obamacare. The latest Kaiser health reform tracking pollhas only 22 percent of respondents saying they’ve heard “a lot” or “some” about the exchanges (and among the unemployed, that number is only 12 percent). So there’s little expectation built up that health reform should be judged by how the exchanges work.

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