# Effect of ACA on politics now that it is going into effect **URL:** \ **Category:** Great Debates\ **Created:** [September 30, 2013, 4:40pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017 "2013-09-30T16:40:59Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Farin](https://avatars.discourse-cdn.com/v4/letter/f/e79b87/32.png) [@Farin](https://boards.straightdope.com/u/Farin)\ **Post date:** [September 30, 2013, 7:14pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/21 "2013-09-30T19:14:03Z")
> [@GIGObuster](#): > > That was the Republican plan anyhow. The ACA is based on the template Republicans that the Republicans recommended to use against the Clinton Health care plan. That’s not really true. Clinton’s Health Security Act was very similar to the ACA. It required that all legal persons in the US have a health plan through an HMO, PPO, or fee-for-service schedule and those under a certain income level would have their plans paid for by the government. Sound familiar? It’s obviously the same health insurance framework that is at the base of the ACA (despite the ACA getting modified for 15 years prior to Obama adopting it as his plan). While it additionally allowed states the opportunity to implement Single Payer, it was up to the state and wasn’t mandated. [Here](http://academic.udayton.edu/health/02organ/clinton02.htm) is an okay breakdown of the Clinton-era health initiative. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [September 30, 2013, 7:56pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/22 "2013-09-30T19:56:41Z")
I just looked it up. Senator John Chafee introduced the Health Equity and Access Reform Today Act of 1993. It apparently includes an individual mandate, a requirement for employers to offer health insurance, eliminated the pre-existing condition issue, provides subsidies to low income earners, and several other similarities to ACA. Senator Chafee’s bill had 20 cosponsors. Of those 20, Senator Grassley and Senator Hatch are still in the Senate. Others were around to vote against Obamacare: Senator Bennett, Senator Bond, and Senator Lugar. I can’t find that companion legislation was introduced in the House. ---
**Author:** ![Saint\_Cad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/saint_cad/32/18907_2.png) [@Saint\_Cad](https://boards.straightdope.com/u/Saint_Cad)\ **Post date:** [September 30, 2013, 8:07pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/23 "2013-09-30T20:07:00Z")
So what if the moderate Pubs led a movement to fix the flaws in Obamacare (like the dichotomy between individual vs. family price controls)? Any political currency with that? ---
**Author:** ![Trinopus](https://avatars.discourse-cdn.com/v4/letter/t/2bfe46/32.png) [@Trinopus](https://boards.straightdope.com/u/Trinopus)\ **Post date:** [September 30, 2013, 8:26pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/24 "2013-09-30T20:26:01Z")
> [@Smapti](#): > > In 25 years, Republicans will be claiming that Obamacare was their idea all along and that Obama was a conservative. . . . I’ll wager the opposite: 25 and 50 years from now, they’ll still be trying to kill it, much as they feel about Social Security. Obama’s name will be anathema to them, just as Franklin Roosevelt’s is today. They never give up their hatreds. ---
**Author:** ![Donald\_Rump](https://avatars.discourse-cdn.com/v4/letter/d/9fc29f/32.png) [@Donald\_Rump](https://boards.straightdope.com/u/Donald_Rump)\ **Post date:** [September 30, 2013, 9:03pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/25 "2013-09-30T21:03:56Z")
Here’s one effect I think we’re likely to see after implementation. For better or for worse, a lot of the public discourse on this law has been conducted at the level of debate-by-anecdote. Particularly during the 2012 campaign, you had all these stories of individual employers (Papajohn’s, for example) saying that they’d have to lay off workers or reduce hours under the yoke of Obamacare. Well, I expect that the anecdotes are suddenly going to become much more favorable to Democrats. You can be sure there will be stories trickling out about such-and-such schmuck in some red state who decided to boycott Obamacare and then woke up to find he had developed colon cancer and is forced to declare bankruptcy. There will be some story about a guy who reluctantly signed up to avoid the penalty, and then got into a car crash and is now thanking his lucky stars for Obamacare. These stories, anecdotal though they will be, are going to be fairly potent against Republican attacks–much more so than trotting out some red-faced construction company owner in Florida bloviating that he can’t make money under Obamacare. So far, Democrats have been basically powerless to retaliiate at that particular level of discourse. ---
**Author:** ![iiandyiiii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iiandyiiii/32/7924_2.png) [@iiandyiiii](https://boards.straightdope.com/u/iiandyiiii)\ **Post date:** [September 30, 2013, 9:23pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/26 "2013-09-30T21:23:02Z")
> [@Saint\_Cad](#): > > So what if the moderate Pubs led a movement to fix the flaws in Obamacare (like the dichotomy between individual vs. family price controls)? Any political currency with that? If they’re not using political-hostage taking as a tactic, then sure. But this “do what we say or the economy gets it!” just isn’t going to fly. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [September 30, 2013, 9:36pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/27 "2013-09-30T21:36:10Z")
> [@Farin](#): > > That’s not really true. Clinton’s Health Security Act was very similar to the ACA. It required that all legal persons in the US have a health plan through an HMO, PPO, or fee-for-service schedule and those under a certain income level would have their plans paid for by the government. > > Sound familiar? It’s obviously the same health insurance framework that is at the base of the ACA (despite the ACA getting modified for 15 years prior to Obama adopting it as his plan). > > While it additionally allowed states the opportunity to implement Single Payer, it was up to the state and wasn’t mandated. > > [Here](http://academic.udayton.edu/health/02organ/clinton02.htm) is an okay breakdown of the Clinton-era health initiative. That link does not go to the Republican proposal, here is a better one that compares the ACA Plan to the Republican proposals of then. > **[Chart: Comparing Health Reform Bills: Democrats and Republicans 2009,...](https://kffhealthnews.org/022310-bill-comparison/)** > > By Maggie MertensKFF Health News Staff WriterFeb. 24, 2010 The proposal President Barack Obama unveiled on Monday is based largely on the bill passed by the Democratic Senate on Dec. 24, 2009, the Patient Protection and Affordable Care... Whoever told you the ACA was not like the Republican plans of the 90s and more like the Clinton one is pulling your leg. ---
**Author:** ![Werekoala](https://avatars.discourse-cdn.com/v4/letter/w/7993a0/32.png) [@Werekoala](https://boards.straightdope.com/u/Werekoala)\ **Post date:** [September 30, 2013, 9:52pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/28 "2013-09-30T21:52:16Z")
Nobody knows what the result will be - after all, they had to pass the Bill before they could find out waht was in it. I do like how we’re already seeing the fallback of “this is just like the Republican plan in the 90’s!” - so if it goes tits up, then the libs can blame the Republicans. ---
**Author:** ![Farin](https://avatars.discourse-cdn.com/v4/letter/f/e79b87/32.png) [@Farin](https://boards.straightdope.com/u/Farin)\ **Post date:** [September 30, 2013, 10:34pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/29 "2013-09-30T22:34:26Z")
> [@GIGObuster](#): > > That link does not go to the Republican proposal, here is a better one that compares the ACA Plan to the Republican proposals of then. > > [Chart: Comparing Health Reform Bills: Democrats and Republicans 2009, Republicans 1993 - KFF Health News](http://www.kaiserhealthnews.org/graphics/2010/022310-bill-comparison.aspx) > > Whoever told you the ACA was not like the Republican plans of the 90s and more like the Clinton one is pulling your leg. I was linking to what I was talking about. Clinton’s Health Security Act. I’m fairly certain I didn’t mention the Republican counter-offer. Who ever told you that I said anything of the sort was pulling your leg. Let’s see what I said: > [@Farin](#): > > Clinton’s Health Security Act was very similar to the ACA. The two in 93/94 weren’t very different from each other. If you recall the rigamarole surrounding both (I know you do), it was largely partisan bickering between two largely similar versions of the same idea. The Ds and Rs both championed a bill that was largely similar in scope and functions. The reason nothing passed in 93/94 was because of partisan tiddlywinks and not because the Rs had a “free market” model and the D’s had a “single payer” model. Now look back at your own link: Boehner’s 2009 bill was quite different from the ACA. It seems the Rs spent time drifting away from the similar ideas they had 20 years ago (despite the Massachusetts Rs participating and endorsing the MassCare bill with the Massachusetts Ds) The Rs had the idea, once, and have grown away from it (which I personally think sucks). The Ds had the idea, once, and updated and came back to it (at least they want healthcare out there, even if I disagree with the solution they picked). Ds don’t get to back away from this now, it was bipartisan slapstick comedy all the way until someone was trying to strike a blow against the other team. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [September 30, 2013, 10:47pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/30 "2013-09-30T22:47:39Z")
> [@ITR\_champion](#): > > United Parcel Service has told its white-collar employees that it will stop providing health care coverage to their spouses who can obtain coverage through their own employers, joining an increasing number of companies that are restricting or eliminating spousal health benefits. Spousal exclusions [have very little to do with Obamacare](http://www.shrm.org/publications/hrmagazine/editorialcontent/2011/1111/pages/1111tobenkin.aspx); they’re just a relatively simple method of cutting costs. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [September 30, 2013, 11:03pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/31 "2013-09-30T23:03:23Z")
> [@Saint\_Cad](#): > > 1. So reading up on a cite to a previous question I wrote. Apparently, illegal immigrants do not have to buy insurance and will not be penalized if they do not have insurance. > > 2. Many people are having their policies cancelled despite President Obama promising you could keep you plan in you wanted. > > 3. Perhaps this is better answered tomorrow when the exchange prices are coming out but it seems many people now are going to pay more for their coverage to cover the high risk pool. > > 4. Individual coverage is limited to 9.5% of your income but the price is unlimited for covering spouses and children - but you still need to cover them. > > 5. Estimates of those previously uninsured that will now have access to insurance has been cut in half by Sibilius. Mostly because the Medicaid mandate was ruled unconstitutional. > > So starting tomorrow when exchange numbers come out and starting 1/1/14 when people need to pay out of pocket. > a) What will the reaction of average Americans be. > b) What impact will it have on 2014 midterms / 2016 presidential election > c) What impact on the repeal Obamacare or change ACA will there be? In a few years it’ll be like Romneycare or medicare part D, something we take for granted and generally like which is why people are trying to kill the bill, they know people will like it (however I don’t get why these same people supported medicare part D, which is also an expansion of government health care. People like Paul Ryan supported that bill). Discussion will be on how to expand the program, not eliminate it. The big problem with our health care is that it costs 2-5x more than anywhere else in the world for the same care. Until that is fixed nothing is going to happen. The ACA just mandates that people buy into a bloated, failed health care system. The average american won’t notice much change. For every horror story (someone getting kicked off their employers plan, someone getting cut to part time hours) there is a good story (someone with pre-existing conditions getting coverage, someone who went above their old lifetime amounts, someone who avoids a recission, etc). ---
**Author:** ![Farin](https://avatars.discourse-cdn.com/v4/letter/f/e79b87/32.png) [@Farin](https://boards.straightdope.com/u/Farin)\ **Post date:** [September 30, 2013, 11:03pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/32 "2013-09-30T23:03:40Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Spousal exclusions [have very little to do with Obamacare](http://www.shrm.org/publications/hrmagazine/editorialcontent/2011/1111/pages/1111tobenkin.aspx); they’re just a relatively simple method of cutting costs. That link leads to a paywall. Care to provide a synopsis? Also, Obamacare led to companies dropping spousal support because they have a way out of some cost. If their spouses have employers that are also required to provide them healthcare, why does UPS (in this case) have to provide it? Pretty much any health care that mandated healthcare to the businesses probably would have made this a reality. On another note: What about kids? If you have a child, who covers that child? One spouse? Both spouses with each company paying 50%? ---
**Author:** ![Farin](https://avatars.discourse-cdn.com/v4/letter/f/e79b87/32.png) [@Farin](https://boards.straightdope.com/u/Farin)\ **Post date:** [September 30, 2013, 11:06pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/33 "2013-09-30T23:06:09Z")
> [@Wesley\_Clark](#): > > (however I don’t get why these same people supported medicare part D, which is also an expansion of government health care. People like Paul Ryan supported that bill). Political brownie points. Making one of the larger (largest yet?) demographics in the country happy means you get re-elected. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [September 30, 2013, 11:07pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/34 "2013-09-30T23:07:43Z")
That’s weird. I accessed the page via Google before without a problem and now I’m paywalled too. It was just a discussion of companies which were adopting spousal exceptions in 2009. “Obamacare” is not synonymous with “rising healthcare costs”. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [October 1, 2013, 12:06am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/35 "2013-10-01T00:06:28Z")
One thing that does not seem to bode well for the future of the exchanges is that it seems that they are going to be largely served by small-time health plans with extremely restrictive networks, at least initially. (And it goes without saying that when you have an extremely restrictive network, it’s not because only the really best doctors are in it.) What this means is that the bigger players think it’s not cost-effective for them to offer coverage to the population which is expected to enroll. And this could become a vicious cycle, as the barebones networks leads only the most desparate to enroll, which increases costs further etc. On another matter, it’s a ludicrous distraction to pretend that the effects of Obamacare are only those which are directly written into the law. When you pass a law, you’re responsible for understanding the direct and indirect consequences of this law. A lot of people pointed these indirect issues out at the time - including on this board FWIW. > [@Ludovic](#): > > I’d like to know how many GOP congresspeople held office in the mid 90s. You can’t really hold the individual members to support of a plan they may not have supported in the first place. > > I’d honestly like to know the answer to this. If it turns out that the majority of GOP congresspeople were in office in the mid 90s, then you _can_ expect them to still support the ACA if they want to be consistent. You’re assuming that the supposed Republican alternative to Hillarycare had unanimous - or even majority - Republican support at the time. It did not. This is a widely repeated myth, so it’s not surprising that people accept it, especially as most people don’t remember the details of anything that was going on 20 years ago. But while it was floated in Republican circles as an alternative to Hillarycare and had mainstream support, it was not at any point the (as opposed to “a”) mainstream Republican position. ---
**Author:** ![Jas09](https://avatars.discourse-cdn.com/v4/letter/j/d07c76/32.png) [@Jas09](https://boards.straightdope.com/u/Jas09)\ **Post date:** [October 1, 2013, 12:14am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/36 "2013-10-01T00:14:28Z")
All you need to know to determine the likely political outcome is how feverishly the GOP is attempting to make sure that it never gets implemented. If they truly thought it would be a disaster why would they be willing to shut down the government (or even default) to stop it? Why not just let it fail, remind everyone every day who’s fault it is, and romp to power? As for a Republican willing to run on reform to Obamacare while leaving community rating, mandatory coverage, and public exchange subsidies? I’d consider voting for them, no doubt. Maybe in 2020. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [October 1, 2013, 12:18am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/37 "2013-10-01T00:18:11Z")
> [@Jas09](#): > > All you need to know to determine the likely political outcome is how feverishly the GOP is attempting to make sure that it never gets implemented. If they truly thought it would be a disaster why would they be willing to shut down the government (or even default) to stop it? Why not just let it fail, remind everyone every day who’s fault it is, and romp to power? Because even if it’s a disaster, it will be a disaster that will be very very hard, if not impossible, to undo. E.g. if it becomes common practice for major corporations to not offer health insurance to their employees, you won’t get them to start doing this again simply by repealing Obamacare at that point. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [October 1, 2013, 12:29am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/38 "2013-10-01T00:29:09Z")
> [@Farin](#): > > I was linking to what I was talking about. Clinton’s Health Security Act. I’m fairly certain I didn’t mention the Republican counter-offer. > > Who ever told you that I said anything of the sort was pulling your leg. Let’s see what I said: > > [QUOTE=Farin] > > Clinton’s Health Security Act was very similar to the ACA. [/QUOTE] Not sure what your point is, there were more differences with the Clinton plan and the ACA than the differences between the Republican plans of the 90’s and Romney care with the ACA. [http://www.politico.com/blogs/bensmith/0310/Obamacare\_vs\_Clintoncare.html](http://www.politico.com/blogs/bensmith/0310/Obamacare_vs_Clintoncare.html) > [@](#): > > The basic shape of the Obama plan is to set up insurance exchanges for the uninsured, people in the individual market today and small businesses that want to join. It also expands Medicaid coverage. “And so the 250 or so million Americans who have either private sector based coverage OR are on a public program like Medicare and Medicaid, are untouched by this,” she emails. > > By contrast, the Clintons’ 1993 plan set up regional alliances, “which were sort of like exchanges, but they covered everyone, so people in employer based coverage today would be shifted into regional alliances,” she writes. > > "In addition, its mandate was a lot tougher, it did have an employer mandate as well an individual mandate and was based on expanding the employer based system - so everyone was to be covered by their employers. (Hence small business opposition: they would be required to cover, rather than just getting an option). > > “This is building an individual system alongside the employer based system, rather than making the whole thing employer based except for the public programs,” Tanden writes. ---
**Author:** ![Trinopus](https://avatars.discourse-cdn.com/v4/letter/t/2bfe46/32.png) [@Trinopus](https://boards.straightdope.com/u/Trinopus)\ **Post date:** [October 1, 2013, 12:37am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/39 "2013-10-01T00:37:45Z")
> [@Donald\_Rump](#): > > . . . I expect that the anecdotes are suddenly going to become much more favorable to Democrats. You can be sure there will be stories trickling out about such-and-such schmuck in some red state who decided to boycott Obamacare and then woke up to find he had developed colon cancer and is forced to declare bankruptcy. There will be some story about a guy who reluctantly signed up to avoid the penalty, and then got into a car crash and is now thanking his lucky stars for Obamacare. . . . Good point. And, in fact, some of this is already happening, with the removal of insurance companies’ ability to deny coverage on the basis of pre-existing conditions, and the extension of parents’ coverage of their children. We’re already getting some of these anecdotes, from people who were about to lose their coverage, but now find themselves protected after all. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [October 1, 2013, 12:43am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/40 "2013-10-01T00:43:26Z")
> [@Fotheringay-Phipps](#): > > You’re assuming that the supposed Republican alternative to Hillarycare had unanimous - or even majority - Republican support at the time. It did not. > > This is a widely repeated myth, so it’s not surprising that people accept it, especially as most people don’t remember the details of anything that was going on 20 years ago. But while it was floated in Republican circles as an alternative to Hillarycare and had mainstream support, it was not at any point the (as opposed to “a”) mainstream Republican position. Not speaking for **Ludovic** , but I was aware of that, the main point I made when that was mentioned in a recent thread was that it was an idea from the Heritage and to me it was a perfect example of a prick that was there to burst the Clinton Plan. There was no intention of pushing it forward and indeed after the “threat” of the Clinton plan was gone there was no interest to offer an alternative. But since the basics of that plan was supported by many business organs, it was then used by Romney in Massachusetts; so it does seem to me that if there were less Tea Party Republicans then we should not be having this discussion now. [Previous page](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017.md?page=1) [Next page](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017.md?page=3)