Friday, July 5, 2019

Can the Democrats Lose a Health Care Election? Sure They Can.

It is truly amazing that in the face of unassailable data, three of the four (at this point) leading contenders for the Democratic nomination have committed themselves to abolishing private health insurance. This could turn what should be the Democrats' best issue into one of their worst--thereby turning 2020 into what shouldn't be possible: a losing health care election.
But that's what could happen when you take an issue on which you generally have a big advantage and stake out a very unpopular position, instead of building on your advantage. The basic contours of that unpopularity are clear. Ron Brownstein:
"Polls have consistently found that most Americans oppose eliminating private health insurance. In a January survey by the nonpartisan Kaiser Family Foundation, just 37 percent of Americans supported a national Medicare for All plan with a ban in place. In a CNN survey released this week, only 21 percent of all Americans said they preferred a national health-care plan that would eliminate private insurance. Such results have prompted alarm from many Democrats—especially but not exclusively centrists—that running in 2020 on a platform of eliminating private insurance could neutralize the advantage Democrats have achieved on health care by defending the ACA."
Michael Tomasky puts it even more starkly:
"[T]his position is political suicide. About 150 million Americans, or roughly two-thirds of all insured people, have private-sector insurance. And contrary to what a lot of Medicare for All backers say, the vast majority of people rate their own coverage as excellent or good.
So the Democrats are really going to campaign on eliminating that in one fell swoop? It’s way over the top. Even Medicare as it exists now doesn’t eliminate private insurance, as about one in four Medicare recipients supplements their coverage with a private plan. So Medicare for All, if it wanted to be true to its name, would allow everyone to do that.
We already know the Trump-GOP talking points here: “OK, so let me get this straight. The Democrats want to do away with private insurance. And they want to replace it with a big, government-run system that will be brought to you by the same party that oversaw the Obamacare rollout. Oh, and by the way, while creating this mayhem, they’re going to raise your taxes by $10,000 or $15,000.”
Or consider this from Colorado Senator Michael Bennet--who is not at all "my" candidate but puts his finger on how badly this would probably go for the Democrats:
"You remember what the pushback was when Barack Obama said, ‘If you like your insurance, you can keep it’? And a couple million people lost their insurance because they had plans that didn’t meet the standards? Imagine a world where our offer is, ‘If you like your insurance, we’re going to take it away from you.’ We just have got to beat Donald Trump at the end of the day here. And so we have to have an agenda that is going to appeal to the American people."
And just to stick the knife in here, consider who the Democrats are in serious danger of the losing if they stick to this ridiculous idea. Brownstein:
"No issue contributed more to the Democrats’ gains in the 2018 midterm elections than the party’s defense of the Affordable Care Act, particularly its provisions protecting patients with preexisting medical conditions. In exit polls during the 2018 election, nearly three-fifths of voters said they trusted Democrats more than Republicans to protect consumers with preexisting conditions. Those voters backed Democrats in House races by a crushing margin of 89 percent to 4 percent. The polling found that the issue was especially important in helping Democrats regain some ground among white women without a college degree, whose support for President Donald Trump was critical to his victories in the three Rust Belt states that effectively decided the 2016 election: Pennsylvania, Michigan, and Wisconsin."
White noncollege women! Democrats should be praying to the gods they can keep their gains among this demographic in 2020. Instead, they are floating ideas pretty much guaranteed to push them away.
So can the Democrats pull themselves back from the brink? One hopes; positions "evolve" and we have certainly seen Kamala Harris, for better or worse, willing to rapidly re-frame her positions (she softened her stance on private health insurance the day after the debate and is now back-pedaling on the busing issue to the point where she more or less agrees with Biden).
And of course, there is one candidate--and still the leading candidate--who specifically disavows eliminating private health insurance. But is Biden the most effective messenger for a plan to build on the ACA, while preserving private coverage for those who want it? Probably not--but at least he's starting out with the right idea. That's more than I can say for his chief competitors at this point.
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Expect way more fighting over health care before the next set of presidential debates.

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