7/20/2017—Gary Abernathy, the publisher and editor of the Times-Gazette of Hillsboro, Ohio, wrote a column for the Washington Post that appeared in the Pittsburgh Post-Gazette last Sunday, entitled Liberals Can’t Fathom How Trump Voters See Health Care. His question concerned a common observation—many people who will be hurt by the repeal of Obamacare still support its repeal.
Abernathy’s conclusion is set forth in this paragraph: “What they fail to grasp is that Mr. Trump’s supporters, by and large, are more dedicated to the principle of freedom from government mandates than they are worried about the loss of government subsidies or programs that social activists in Washington think they need.”
Well, maybe so. That is what I meant by the term “moral heroes” in the title above. There is always opposition in America to anything that smacks of socialism, for example, which is why we don’t have single payer healthcare like other wealthy countries. But maybe Mr. Abernathy is a rich person living out a rich person’s fantasy of pro-market dedication.
The reason I am not convinced is that some of the provisions that clearly help people, such as coverage for preexisting conditions and the age 26 coverage for children, never seem to get directly attacked. Some of the Republican plans would end or limit these provisions, but it is not clear that people understand this. I have yet to hear a single Republican Senator say, look, I’m sorry people get sick but we can’t let the government tell insurance companies they have to insure people who are already sick. If that means they die, they die. Now if people supported that, you might be able to make this free market claim.
What is clear is that some people who have been aided by the Medicaid expansion support plans that would cut back this expansion. But even here, when I listen to my own Senator, Pat Toomey, who is a big part of limiting Medicaid expansion, he says no one will lose coverage right away and he only wants to make the program sustainable.
Then there is racism and bias against the poor. It is true that Americans often support cutbacks in programs that help them, but never the programs that help everyone or seemingly deserving groups like veterans. No one ever says that social security encourages irresponsible lifestyles, for example, or discourages saving. No one says deposit insurance interferes with the banking market. And isn’t Medicare socialism for the elderly? But no one ever wants to limit that.
No, it is only programs like food stamps and Medicaid, which aid only the poor, or relatively poor, and which are identified, wrongly, as mostly helping people of color. Is cutting back on those programs opposition to government mandates or just prejudice?
But don’t people who have benefited from Obamacare support its overall repeal? Yes, many do. But Obamacare always suffered from a perception gap. Even the people it helped did not feel that it did help them. Not that it helped them but people remained opposed in principle to government intervention—that would happen if people supported cutting their social security payments. Medical insurance premiums still went up. Healthcare was still costly and difficult. Maybe that means Obamacare was not a good program, but it does not mean that people oppose government help or even mandates.
Look at President Trump’s rhetoric. For the most part, he has said that people are hurting under Obamacare and we need a system that better helps people. That might be cynical or unattainable, but it is not the rhetoric of the free market. It is almost the opposite.
Finally, look at how the politics have shifted on Obamacare. In the polls, repeal was very popular for a long time. So popular that Democrats stupidly ran away from Obamacare rather than explain and defend it. That turned out to be a disastrous strategy because they still got the blame for perceived failures. Even Bill Clinton criticized Obamacare during the Presidential Campaign.
But, now, when repeal is actually at hand, the polls really have shifted. That suggests to me that the public now has a clearer idea of who actually might be hurt by repeal.
I don’t think the public is opposed to government mandates on healthcare. In fact, I bet single payer would be more popular now than ever before. And will be even more popular once President Trump succeeds in killing Obamacare one way or another.