Conservatives just can’t catch a break in polls since the shutdown. One might expect that at very least the numbers supporting Obamacare might have dropped considering how terrible the initial opening of the exchanges has gone. No, instead approval has increased in several recent polls, including Gallup.
Despite the highly publicized technical issues that have plagued the government’s health insurance exchange website that went live on Oct. 1, Americans’ views of the Affordable Care Act are slightly more positive now than they were in August. Forty-five percent now approve of the law, while 50% disapprove, for a net approval score of -5. In June and August, net approval was slightly lower, at -8.
Keep in mind that any poll regarding approval of the Affordable Care Act can falsely show decreased support because many of those who oppose the law do so because they believe it should do more, or want a single payer plan. There is also considerable misunderstanding of the law, with many people supporting the components of Obamacare when polled while also saying they oppose Obamacare when asked separately.
There are a couple of reasons why support might be going upwards despite the computer problems. This could be part of the overall backlash against Republicans and everything they stand for seen in recent polls. I wonder if coverage of what the exchanges are intended to do is leading to more support for the Affordable Care Act, which is more meaningful than probable temporary computer glitches. The administration has had excellent success with computers when used to revolutionize politics. I think that at times they are also overly optimistic about what computers can do, from handling the complexity of the insurance exchanges to their views on electronic medical records. We have lived with computers long enough to know that glitches are common with a new product, but this does not mean that we don’t adopt the new technology over time. Plus, in this situation, the use of computer exchanges to purchase health coverage says nothing about the quality and affordability of care once insurance coverage is purchased. The most important outcome so far is that insurance costs do appear to be lower than expected due to the exchanges.
We also must keep in mind that the Affordable Care Act is far from perfect, and the final law is not exactly what most people wanted. The question is not whether Obamacare is perfect, but whether it is a major improvement over what was in place in the past. Greg Sargent also reminds us that Obamacare passes another important comparison despite the initial problems: “We can keep two ideas in our heads at the same time. The first: Obamacare’s rollout is awful and demands accountability. The second: GOP criticism of the rollout is deeply incoherent and indicative of a larger refusal — one that has gone on for years — to participate seriously in the basic governing necessary to solve this pressing national problem.”
Most conservatives cannot keep these two ideas in their head (and few can even manage one). They see the problems with the roll out as indicative of problems in the overall concept. Others such as Ross Douthat realize that the failure of the conservative aspects of the plan could lead to an even more liberal alternative. Mike Konczal has argued that the exchange problems stem from more conservative or neoliberal ideas included in the Affordable Care Act (which was essentially the conservative Heritage Foundation’s alternative to Hillarycare). He looked at the politics and argued that a true government-run plan “while conceptually more work for the government, can eliminate a lot of unnecessary administrative problems.”
Some of the more cartoony conservatives argue that this is a failure of liberalism because it is a failure of government planning, evidently confusing the concept of economic “central planning” with “the government makes a plan to do something.”
However, the smarter conservatives who are thinking several moves ahead (e.g. Ross Douthat) understand that this failed rollout is a significant problem for conservatives. Because if all the problems are driven by means-testing, state-level decisions and privatization of social insurance, the fact that the core conservative plan for social insurance is focused like a laser beam on means-testing, block-granting and privatization is a rather large problem. As Ezra Klein notes, “Paul Ryan’s health-care plan — and his Medicare plan — would also require the government to run online insurance marketplaces.” Additionally, the Medicaid expansion is working well where it is being implemented, and the ACA is perhaps even bending the cost curve of Medicare, the two paths forward that conservatives don’t want to take.
The old status quo in which insurance companies profited by finding ways to deny coverage to those with expensive medical problems and affordable insurance was becoming increasingly difficult to obtain was not a viable option. The choices were either continuation of private insurance with increased government involvement, as with the Affordable Care Act, or a single-payer plan. Conservatives should be happy about the outcome if they are willing to back away from the extremism of opposing everything which Obama supports. If the exchanges turn out to be too complicated, especially with Republicans attempting to prevent their success (or as Ed Kilgore put it, have unclean hands) as opposed to participating in the process, the choice then become a more simple single-payer plan, not turning to the incoherent alternatives being proposed by Republicans.