Ezra explains why the White House isn’t going to run on its health care accomplishment:
If the Affordable Care Act is ever going to become the popular piece of law that its supporters hope it is, it’s not going to be because Democrats finally figure out the magic jingle necessary to sell it. It’s going to be because it sells itself by providing insurance to 30 million Americans. But it doesn’t really start doing that until 2014. The question for the law’s supporters is how to keep it alive until then. And the answer, at least in the White House, is simple: Reelect Obama.
I see the logic from a political perspective. Mitt Romney will surely do his best to dismantle the reforms if he wins, therefore, to protect the reforms it’s important to have Obama in office when they are slated to take effect. And since the “plan”, to the extent people understand it, which isn’t very much, is unpopular, I’m guessing the Republicans will do whatever they can to ensure the people continue to be as misinformed as possible.
There are several problems with this. The first is that implementation is only 2 years away now and a large portion of the people who are going to be immediately affected — the working poor and those who currently don’t have health insurance, don’t have a frigging clue about what they’ll need to do and what effect this law will have on them. At some point someone’s going to have to tell them. Maybe this outreach is being left to the exchanges which don’t exist yet, but I’m guessing that it’s only in certain places where that they’re going to be up to speed to inform the public of the plan. I hope they’re working on it all over the country or we’re going to have a very lousy buy-in in 2014 and that could result in some very unhappy people and some unpleasant headlines on April 15th 2015.
I don’t think anybody’s asking the White House for “magic jingles”, but somebody is going to have to explain this thing. In order for it to “sell itself” we need millions of people to sign up for Medicaid (if their states decide to accept it, that is) and many others to buy health insurance who don’t already have it. And then we need for the entire country to be aware of this and happy for all those people who are now on Medicaid and government subsidies.
Even though the vast majority will see no positive or negative change they will hear a constant drumbeat from the right that the thing is bankrupting the country and every problem with the insurance company it will now be the government’s fault. And many of them will see someone benefiting from the reforms, see nothing for themselves, and assume it’s at their expense. It will be very easy to turn health care into welfare in many of these people’s minds.
Here’s where public opinion stands today, after the ruling:
( I suppose that the 27% of Democrats who want to repeal all or part of the law are single-payer or public option advocates. That’s almost a third of the party. Not insignificant …)
Perhaps the American people will all settle down about this in 2014 when they see how wonderful the plan is working for those who didn’t have insurance and now have it. It would be pretty to think so, anyway. But I’m guessing those numbers are only going to harden until it can be demonstrated to most people that they aren’t losing anything, not that they didn’t gain. With Republicans out there screaming about parasites and welfare queens and the largest tax increases in history, I don’t think it’s going to be as easy as people think it is.
This will be a battle for perceptions among the majority who are covered under their employers or have Medicare, not reality. Their stake in this is abstract and that abstraction can be defined just as easily in a negative way as a positive way. One of the main reasons that Social Security and Medicare worked was that every last person was in it and once they were in it they didn’t want to lose it. This plan does not feature that sort of buy-in. I really think it’s a huge, huge mistake for the Democrats to be sanguine about this plan selling itself.
Maybe the president can’t produce a “magic jingle” to sell this thing, but somebody needs to. (I vote for Will.I Am.)
