# 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:** 12\ **Page:** 3
**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:** [October 1, 2013, 1:08am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/41 "2013-10-01T01:08:12Z")
> [@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? I admit I’m fighting the hypothetical here: but moderate Republicans are scared blind by having right-wing conservatives make primary challenges against their reelection. I just can’t imagine that there’s any serious effort by moderate Republicans to actually fix the problems that emerge, because that would be basically the kiss of death for their political career. That’s one of the fundamental reasons why we find ourselves in the absolutely ridiculous situation: Republicans are signing up to crazy, right-wing ideas because they are intimidated into no longer following their conscience. ---
**Author:** ![Farin](https://avatars.discourse-cdn.com/v4/letter/f/e79b87/32.png) [@Farin](https://boards.straightdope.com/u/Farin)\ **Post date:** [October 1, 2013, 1:24am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/42 "2013-10-01T01:24:34Z")
> [@GIGObuster](#): > > 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) :dubious: Your own source lists only the two major differences between the two, which are just different takes on the same thing. Now, granted, the R plan of the day had the health exchanges versus the alliances, and the mandate cuts off for small businesses, like it does with Obama’s plan. But they are still incredibly similar. If the R (or D) plan ousted the insurance companies as middlemen and instead did Single Payer or some sort of Government-Run insurance program, then I’d concede that they aren’t very similar. But they really do the same thing in slightly different global implementations. Go read the link I posted earlier about the contents of the Clinton HSA. You’ll feel like you’re reading ACA as it was passed in 2009 for most of it. (Stop reading after page 15. I don’t want you to get a nose bleed. 🙂 ) > [@GIGObuster](#): > > 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. Yeah. It was introduced within the week (my brain says it was introduced on a Wednesday when the original bill was introduced on a Monday, but that’s 20 years out of date) and only used to say “We have ideas and principles, too!” and once the Ds stopped pushing the Rs dropped it to stare at their navels. Like I said, the Rs drifted away from the plan that was feet apart in 93 and proposed a plan in 09 that was Astronomical Units apart. But the ACA/HSA/HEART/MassCare plans are very, very close together, even though they aren’t identical. > [@Ravenman](#): > > I admit I’m fighting the hypothetical here: but moderate Republicans are scared blind by having right-wing conservatives make primary challenges against their reelection. I just can’t imagine that there’s any serious effort by moderate Republicans to actually fix the problems that emerge, because that would be basically the kiss of death for their political career. > > That’s one of the fundamental reasons why we find ourselves in the absolutely ridiculous situation: Republicans are signing up to crazy, right-wing ideas because they are intimidated into no longer following their conscience. I agree. The term “RINO” has been an incredibly effective tactic against the “impostors” of the Republican centrists. I often with that they would jump ship to Independent and see if they could get their constituents to follow. The bleeding of one of the parties would probably do a lot to stop the far left versus far right political BS. Or maybe I’m too hopeful, again. Either way, watching one of the parties hemorrhage would give a nice amount of schadenfreude. 😃 ---
**Author:** ![Farin](https://avatars.discourse-cdn.com/v4/letter/f/e79b87/32.png) [@Farin](https://boards.straightdope.com/u/Farin)\ **Post date:** [October 1, 2013, 1:32am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/43 "2013-10-01T01:32:00Z")
> [@Farin](#): > > :dubious: Your own source lists only the \*\*two \*\*major differences between the two, which are just different takes on the same thing. Sorry, three major differences: Clinton’s HSA also allowed a state to break from the regional alliance and institute a form of Single Payer. (The insurance companies lobbied hard against this, as I recall.) It probably would have only been the coastal states that implemented it, but at least it would have started. ☹ ---
**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, 2:02am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/44 "2013-10-01T02:02:26Z")
> [@Fotheringay-Phipps](#): > > 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. But we are talking about the political effects, not the practical ones. A disastrous policy created and defended by one party by itself surely must accrue benefits to the other party, no? I understand that the GOP may also have practical objections to the ACA, and how much their current actions are based on those practical objects rather than political concerns is a ripe area for debate. As an aside - why would the GOP be opposed to a world in which health care was decoupled from employment? That actually sounds much closer to a free market than what we currently have… ---
**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:** [October 1, 2013, 2:16am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/45 "2013-10-01T02:16:30Z")
> [@Farin](#): > > Political brownie points. Making one of the larger (largest yet?) demographics in the country happy means you get re-elected. Millennials are a bigger % of the electorate than those 65+ and the GOP aren’t trying to appeal to them. Latinos either (although latinos are only about 12% of the electorate). ---
**Author:** ![Farin](https://avatars.discourse-cdn.com/v4/letter/f/e79b87/32.png) [@Farin](https://boards.straightdope.com/u/Farin)\ **Post date:** [October 1, 2013, 2:20am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/46 "2013-10-01T02:20:21Z")
> [@Jas09](#): > > But we are talking about the political effects, not the practical ones. A disastrous policy created and defended by one party by itself surely must accrue benefits to the other party, no? > > I understand that the GOP may also have practical objections to the ACA, and how much their current actions are based on those practical objects rather than political concerns is a ripe area for debate. > > As an aside - why would the GOP be opposed to a world in which health care was decoupled from employment? That actually sounds much closer to a free market than what we currently have… The problem (all around) is that Insurance and Health Care have become huge profit makers. So if you decouple from employers (who not only generally pay all the health care costs absorbed above a certain amount, but also pay administration fees to the insurance company) those profit makers lose business. Which means a dip in political contributions. ---
**Author:** ![Farin](https://avatars.discourse-cdn.com/v4/letter/f/e79b87/32.png) [@Farin](https://boards.straightdope.com/u/Farin)\ **Post date:** [October 1, 2013, 2:26am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/47 "2013-10-01T02:26:54Z")
> [@Wesley\_Clark](#): > > Millennials are a bigger % of the electorate than those 65+ and the GOP aren’t trying to appeal to them. Latinos either (although latinos are only about 12% of the electorate). According to this, in [2010](http://en.wikipedia.org/wiki/File:USpop2010.svg) the 65+ crowd was about 40 million and the 20-29 crowd was about 40 million as well. And the GOP has always struggled with minority voters. I suspect with the minorities growing and growing in proportion of the population, that that’ll probably end the party (long range end. Like 2050 or 2075) if they don’t get on board with the fact that other peoples are people, too. ---
**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, 2:37am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/48 "2013-10-01T02:37:42Z")
> [@Jas09](#): > > But we are talking about the political effects, not the practical ones. A disastrous policy created and defended by one party by itself surely must accrue benefits to the other party, no? > > I understand that the GOP may also have practical objections to the ACA, and how much their current actions are based on those practical objects rather than political concerns is a ripe area for debate. ISTM that your first paragraph (& prior post) rely on your second paragaph here. You’re assuming that the Republicans have no genuine core beliefs and act solely according to whatever benefits them politically. Once you start from that premise, you can then claim that Republican objections to Obamacare must necessarily be based on the realization that it’s bad for them politically. That seems somewhat circular. You start with the premise that Republicans are driven solely by political considerations, and use this to prove that they must be opposing the ACA based on political considerations, and use this to prove that they know that the ACA is a political winner for the Democrats, and then in turn prove that the Republicans must be opposed to it for that reason. The alternative is that the Republicans - much like the Democrats - are motivated by a mixture of politics and principle, and oppose the ACA largely because it conflicts with their (mostly small government) principles. They are afraid, as above, that once implemented, the ACA, like other major government programs that came before it, will change the landscape such that it will be impossible to repeal, which will create a permanent victory for big government etc. > [@](#): > > As an aside - why would the GOP be opposed to a world in which health care was decoupled from employment? That actually sounds much closer to a free market than what we currently have… Health insurance is different than a lot of other products, in that it’s not very viable as an individual product, being subject to what’s known as anti-selection, i.e. the tendency of people who know they will be high cost to purchase the product. In order to be viable, it’s necessary to have some sort of subsidy, such that it will be worthwhile for low-cost people to buy the product. Right now, the only two options for subsidizing it are businesses driven by competitive pressures and the government. Conservatives would generally prefer businesses driven by competitive pressures. ---
**Author:** ![Werekoala](https://avatars.discourse-cdn.com/v4/letter/w/7993a0/32.png) [@Werekoala](https://boards.straightdope.com/u/Werekoala)\ **Post date:** [October 1, 2013, 3:59am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/49 "2013-10-01T03:59:37Z")
> [@Wesley\_Clark](#): > > Millennials are a bigger % of the electorate than those 65+ and the GOP aren’t trying to appeal to them. Latinos either (although latinos are only about 12% of the electorate). Two of the biggest “gimmie” cohorts are driving this disastrous program. I’m shocked - SHOCKED. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [October 1, 2013, 5:46am UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/50 "2013-10-01T05:46:59Z")
> [@Werekoala](#): > > Two of the biggest “gimmie” cohorts are driving this disastrous program. I’m shocked - SHOCKED. That’s two random threads in a row I’ve looked at that you’ve posted something similar in. Maybe if you understood the issues, you’d seethe a bit less? ---
**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, 2:37pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/51 "2013-10-01T14:37:31Z")
> [@Fotheringay-Phipps](#): > > ISTM that your first paragraph (& prior post) rely on your second paragaph here. You’re assuming that the Republicans have no genuine core beliefs and act solely according to whatever benefits them politically. Once you start from that premise, you can then claim that Republican objections to Obamacare must necessarily be based on the realization that it’s bad for them politically. > > That seems somewhat circular. You start with the premise that Republicans are driven solely by political considerations, and use this to prove that they must be opposing the ACA based on political considerations, and use this to prove that they know that the ACA is a political winner for the Democrats, and then in turn prove that the Republicans must be opposed to it for that reason. You’re correct, it is circular- logic fail on my part. I actually think that the GOP does have core beliefs, and they have been extremely unified and consistent in opposing the government expansions that are part of the ACA. What I think goes beyond practical concerns is the current tying of the CR to an effort to defund or delay. It’s harder for me to square a genuine concern over the practical effects of the law with the sort of purely political machinations we are seeing now. > [@](#): > > The alternative is that the Republicans - much like the Democrats - are motivated by a mixture of politics and principle, and oppose the ACA largely because it conflicts with their (mostly small government) principles. They are afraid, as above, that once implemented, the ACA, like other major government programs that came before it, will change the landscape such that it will be impossible to repeal, which will create a permanent victory for big government etc. That is certainly possible. But that ship sailed when Obama won reelection, the Democrats held the Senate, and SCOTUS upheld the individual mandate. Surely the GOP knows this, right? So the rational pragmatic approach is to produce and sell small-government solutions that fit within the framework. The fact that they aren’t doing that is what makes me suspicious of their claims that it will be a disaster. > [@](#): > > Health insurance is different than a lot of other products, in that it’s not very viable as an individual product, being subject to what’s known as anti-selection, i.e. the tendency of people who know they will be high cost to purchase the product. In order to be viable, it’s necessary to have some sort of subsidy, such that it will be worthwhile for low-cost people to buy the product. Right now, the only two options for subsidizing it are businesses driven by competitive pressures and the government. Conservatives would generally prefer businesses driven by competitive pressures. This is nice, and I think a reasonable framing of (part of) the problem. And the big problems for the non-government-intervention side is (a) it’s hard to see how businesses driven by competitive pressures will subsidize insurance for the under/unemployed and (b) there are, to the best of my knowledge, exactly zero systems in the world that have minimal government intervention and actually work. ---
**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, 4:18pm UTC](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017/52 "2013-10-01T16:18:21Z")
> [@Jas09](#): > > What I think goes beyond practical concerns is the current tying of the CR to an effort to defund or delay. It’s harder for me to square a genuine concern over the practical effects of the law with the sort of purely political machinations we are seeing now. Definitely some politics mixed in there. And the fact that the Democrats pushed through a bill of this magnitude over virtual unanimous Republican opposition, using unprecedented parliamentary maneuvers, undoubtedly plays into it as well. This type of thing is extremely common in politics, as I said in my earlier post. Most politicians start off with some core principles, but few if any are indifferent to political considerations. (If they were, they wouldn’t last long in politics.) More below. > [@](#): > > That is certainly possible. But that ship sailed when Obama won reelection, the Democrats held the Senate, and SCOTUS upheld the individual mandate. Surely the GOP knows this, right? Some do, some don’t. The effects ofthe ACA on the private market will not all happen overnight. They would happen slowly. The longer the ACA is allowed to exist unchallenged, the more it will gradually distort the health insurance and health care markets. So the idea is apparently - to the extent that it’s motivated by practical considerations - to keep things up in the air and keep the program from succeding for as long as possible in the hope that there will be favorable election results before the program is completely unrepealable. But again, there’s no doubt that there are also some political and emotional considerations involved as well. > [@](#): > > So the rational pragmatic approach is to produce and sell small-government solutions that fit within the framework. The fact that they aren’t doing that is what makes me suspicious of their claims that it will be a disaster. Problem is that in the current environment these ideas are all non-starters. So a lot of people are not all that motivated to work on coming up with proposals that have zero chance of being enacted anytime soon, and some who actually have done things along these lines have been ignored, for the same reason. > [@](#): > > And the big problems for the non-government-intervention side is (a) it’s hard to see how businesses driven by competitive pressures will subsidize insurance for the under/unemployed and (b) there are, to the best of my knowledge, exactly zero systems in the world that have minimal government intervention and actually work. (a) under/unemployed people tend to be a lower priority for Republicans for reasons that are beyond the scope of this thread and (b) “actually work” is a relative and very subjective term. [Previous page](https://boards.straightdope.com/t/effect-of-aca-on-politics-now-that-it-is-going-into-effect/670017.md?page=2)