Future of Obamacare Has Many Possible Paths According to Specialist (Red Dirt Report)

By Brett Dickerson

On November 10 Dr. Lawrence Jacobs from the University of Minnesota gave a presentation on the future of the Affordable Care Act or “Obamacare” especially in light of the fresh election results from just a few days before. He is the Director of the Center for Study of Politics & Governance at the Humphrey School & Department of Political Science, University of Minnesota. The presentation was sponsored by the Oklahoma Scholars Strategy Network and Oklahoma Policy Institute.

What is the future for Obamacare in the U.S. and Oklahoma?

Jacobs presented some ideas about how and why Oklahoma could be using ACA dollars that it is currently leaving on the table for no other reason than political spite. But first, he showed some striking results of current surveys on attitudes and feelings about the ACA:

At exit polls Democrat and Republicans voters showed to be nearly evenly split on whether the ACA went too far or is about right/or has not gone far enough.

The Kaiser Family Foundation Health Tracking Poll (Aug. 25-Sept. 2, 2014) found that overall, 63 percent of those polled were in favor of improving the law rather than repealing it and replacing it with something else. Of course those who were favorable in the first place are much more in favor of working to improve the law. But it is interesting that among those who say that they are not favorable to the law, 40 percent say that they would still rather see the law’s problems fixed rather than going through another process of repealing and then replacing it.

In that same poll, 89 percent of Democrats, 59 percent of independents, and 35 percent of Republicans were in favor of working to fix the law rather than repeal and replace. So there is already wide acceptance of the law with a concern to fix problems that may exist within it rather than going through another lengthy fight, and spending much more money to set something else up.

In trying to understand the overall panic on the right to lock as much down as they can as quickly as they can is the reality of the changing demographics in the U.S. According to a Pew Research Center study in 2008, whites will have moved from 67 percent of the U.S. population in 2005 to 47 percent by 2050. The most dramatic increase will be among Hispanics with a wide shift from being 14 percent in 2005 to 29 percent in 2050.

Obamacare repeal is not a slam-dunk

Jacobs gave his analysis of why it will be harder for a GOP controlled Congress to make the kinds of sweeping changes that they are loudly promising now.

Republicans won in part during this election cycle because they found ways to keep from antagonizing liberals prior to the election. Jacobs contends that they will want to continue that strategy because they will be facing tougher odds in 2016. In 2014 all but one of the Senate seats up for re-election were held by Democrats in states where Obama lost in 2012. But in 2016, the same total number of Senate seats – seven – will be due for re-election with ALL of them being held currently by Republicans in states where Obama won in 2012.

So there will be a high degree of sensitivity by Republicans to not antagonize those blue states where Republican Senators will have to fight for their political lives in 2016.

In addition, Jacobs pointed out that the national Republican Party is not the monolith that it often appears to be, especially to those on the Left. This is especially true when it comes to ideas within the party about how to win in 2016. The Cruz wing will argue that they must take radical measures against all things Obama in order to win. Jacobs pointed out that although this is one part of the argument within the GOP, it’s not all of it.

There will be “loss aversion” in the GOP, as Jacobs described it. Another wing of the Republican Party will want to consolidate gains that they made in this last election cycle while trying not to lose the Senate again in an election that could be equally as hard for them in 2016 as it was for Democratic incumbents in this year.

You may view his whole PowerPoint which includes this data at OKPolicy.org.

Most likely scenario for Oklahoma

After his speech he spoke to Red Dirt Report about the situation in Oklahoma.

For a red state like Oklahoma, what do you think is the most likely scenario? “I think the idea of Washington doing this is appalling. The challenge is finding a way to make it the Oklahoma solution. This would involve fitting into what Oklahoma is already doing.”

He then referred to a health insurance exchange that has already been successfully under way in Oklahoma, only just for employers and their employees. “Insure Oklahoma is something that the state’s proud of. It’s a way to work with that. You can look at that Arkansas private option and there are some similarities there. There are ways to do reform that are very supportive of the conservative agenda. Tax cuts are something that Republicans who I know would welcome.”

Considering how strongly opposed to Obamacare many conservatives in Oklahoma have been, Jacobs said, “The key thing for Oklahoma is that health reform is not about Obamacare. That guy’s gone. He’s in the history books. It’s really about what makes sense for Oklahoma.”

The realities of continuing to not accept flexible monies that are offered to Oklahoma just out of political spite are costing us, according to Jacobs.

“As Oklahoma wrestles with its budget, as it wrestles with the fact that it’s paying millions of dollars for charity care that gets passed on [to taxpayers], as it sees its safety net hospitals and frankly a part of the middle class struggling to pay bills, there are Oklahoma solutions to those problems, and nothing to do with Obamacare. I’m seeing Republican states all around the country putting on their thinking caps.”

“My bottom line on all of this is, time to put on our thinking caps. It’s time to put away all of the sloganeering and the hot-headed politics.”

When Red Dirt Report asked about how a concerned Republican legislator could do that, he said, “I think that the Arkansas example is a good one. It strikes me as making a lot of sense for Oklahoma and fits what you have already been doing with Insure Oklahoma. You could use some of that money for tax cuts, or for bringing down the budget or just the Republican fiscal agenda.”

The next two years promise to be very active ones as the Republican Party takes control of the entire Congress in the next session and the Republican Party in Oklahoma exerts even more dominance over the Legislature.


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